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Combining Minimally Invasive Direct Coronary Artery Bypass Grafting with Transapical Aortic Valve Implantation-The Next Level Heart Team Approach.
Miazza, Jules; Vasiloi, Ion; Koechlin, Luca; Gahl, Brigitta; Santer, David; Berdajs, Denis; Nestelberger, Thomas; Kaiser, Christoph; Eckstein, Friedrich; Reuthebuch, Oliver.
Afiliación
  • Miazza J; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Vasiloi I; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Koechlin L; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Gahl B; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Santer D; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Berdajs D; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Nestelberger T; Department of Cardiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
  • Kaiser C; Department of Cardiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
  • Eckstein F; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
  • Reuthebuch O; Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
J Clin Med ; 12(21)2023 Nov 01.
Article en En | MEDLINE | ID: mdl-37959355
We present the results of a combined approach for transapical aortic valve replacement and minimally invasive coronary artery bypass grafting (taTAVI-MIDCAB) in patients with combined aortic stenosis and coronary artery disease. BACKGROUND: For patients presenting with aortic stenosis and coronary artery disease, a simultaneous procedure addressing both diseases is recommended to reduce operative risk. In high-risk patients with hostile femoral or coronary axis, taTAVI-MIDCAB can be an alternative minimally invasive approach, offering the benefits of left interior mammary artery to left anterior descending coronary artery (LIMA-LAD) grafting. METHODS: From 2014 to 2022, 10 patients underwent taTAVI-MIDCAB for combined coronary and severe aortic stenosis in the hybrid operation theater at our institution. We assessed perioperative outcomes and follow-up outcomes. RESULTS: The median age was 83 years (81 to 86). The procedure was successfully performed in all patients without conversion to sternotomy. The median length of hospital and intensive care unit stay was 9 days (7 to 16) and 2.5 days (1 to 5), respectively. The median flow over the coronary artery bypass was 31 (22 to 44) mL/min, with a pulsatility index (PI) of 2.4 (2.1 to 3.2). Mild paravalvular leak occurred in 2 patients (10%). There were no neurological events nor acute kidney injury. Pacemaker implantation was required in 1 patient (10%). CONCLUSIONS: Simultaneous surgical coronary revascularization and interventional valve implantation in the setting of a hostile femoral and coronary axis appears to be safe and beneficial.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza