Combined Total Arterial Off-Pump Revascularization and Direct Aortictranscatheter Valve Implantation in High-Risk Patients with Coronary Artery Disease and Aortic Stenosis

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
F. Schlingloff ◽  
C. Frerker ◽  
U. Schäfer ◽  
M. Schmoeckel ◽  
R. Bader
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Stenosis ◽  
Off Pump ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease ◽  
Valve Implantation

Transaortic Transcatheter Aortic Valve Implantation and Concomitant off Pump Revascularization

2016 ◽  
Vol 11 (5) ◽  
pp. 363-366 ◽  
Author(s):  
Hardy Baumbach ◽  
Samir Ahad ◽  
Stephan Hill ◽  
Tim Schäufele ◽  
Sara Adili ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Revascularization ◽  
Off Pump ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Artery Disease ◽  
Valve Implantation

An increasing number of patients with severe aortic stenosis and concomitant critical coronary artery disease were referred to our hospital. Some of those patients were classified as high-risk patients qualifying for a transcatheter therapy with the additional need for coronary revascularization. As a consequence of their comorbidities, the established transapical as well as transfemoral approach were either not possible or not favored owing to the indispensable need for coronary revascularization. We present 4 successfully combined off-pump procedures consisting of a transcatheter aortic valve implantation (Edwards SAPIEN XT) via the transaortic approach and an off-pump coronary artery bypass grafting. All patients were discharged free from stroke, myocardial infarction, or access site complications either to rehabilitation facility or to the referring hospital with none or trace aortic regurgitation and patent grafts. These cases confirm the feasibility of those combined operations and should be considered as realistic alternative for surgical treatment in high-risk patients who are clearly identified to benefit from transcatheter approach to treat aortic stenosis and who have severe concomitant coronary artery disease.

Management of High-Risk Patients With Aortic Stenosis and Coronary Artery Disease

2013 ◽  
Vol 95 (2) ◽  
pp. 599-605 ◽  
Author(s):  
Daniel Wendt ◽  
Philipp Kahlert ◽  
Tim Lenze ◽  
Markus Neuhäuser ◽  
Vivien Price ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Stenosis ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

scholarly journals Predictors of coronary artery disease progression among high-risk patients with recurrent symptoms

Heart Views ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 45
Author(s):  
MouazH Al-Mallah ◽  
Iyad Farah ◽  
AmjadM Ahmed ◽  
Raed Odeh ◽  
Eltayyeb Alameen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Disease Progression ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease ◽  
Coronary Artery Disease Progression

scholarly journals P976 Can calcium score predict the appropriate treatment for high risk patients? (a 5 years follow up study)

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Stanciu ◽  
M Gurzun ◽  
S Dumitrescu ◽  
F Naftanaila ◽  
A Spanu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Bypass Graft ◽  
Calcium Score ◽  
Agatston Score ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

Abstract Coronary artery calcium score (CAC) measures the calcium contained in the artery wall and it is evaluated using multi-slice cardiac CT and CAC represents a useful tool for appreciating the burden of coronary atherosclerosis and for determining the risk for cardiovascular events. The purpose of this study is that CAC can be use for guiding treatment strategy in patients classified as high risk based on Framingham score . We prospectively enrolled 64 pts (79% male), 62,7+/-5 year, between 2002-2017. All included patients were considered high risk based on EuroSCORE model. A multislice heart CT scan was performed for every patient with CAC score determination quantified with the Agatston score and expressed as Agatston Units (AU). The patients were divided in 3 groups according to the treatment that they received during the 5 years follow up: optimal medical treatment for coronary artery disease (OMT) – 35.9% (23), percutaneous coronary angioplasty (PCA) – 29.7% (19) and coronary artery bypass graft (CABG) – 34.4%. The CAC score for pts treated by OMT vs CABG +/_ PCA were compared using the ROC curves. CAC score was statistically significantly superior in CABG+ PCA patients versus OMT (AUC: 0.96, p < 0.001 vs AUC 0.42, p = 0.212). Also, a comparison of CAC score score for CABG vs OMT revealed the same results (AUC: 0.96, p< 0.001 vs AUC: 0.42, p = 0.264). OMT vs CABG + PCA presented a cut-off value of 382 AU with a specificity of 90% and a sensitivity of 95%. OMT vs CABG presented a cut-off value of 530 AU with a specificity of 89% and a sensitivity of 95%. In conclusion, CAC score has a good predictability and sensitivity in determining the outcome and can be a promising tool to guide therapy in high risk patients, mainly regarding medical vs surgical treatment for coronary artery disease.

Prospective Studies Evaluating Prophylactic ICD Therapy for High Risk Patients with Coronary Artery Disease

1993 ◽  
Vol 16 (3) ◽  
pp. 564-570 ◽  
Author(s):  
HELMUT KLEIN ◽  
HANS JOACHIM TRAPPE ◽  
HANS GERD FIEGUTH ◽  
SEAH NISAM
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Prospective Studies ◽  
Icd Therapy ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

scholarly journals Impact of Diabetes Mellitus on Outcomes after High-Risk Interventional Coronary Procedures

2020 ◽  
Vol 9 (11) ◽  
pp. 3414
Author(s):  
Laura Johannsen ◽  
Julian Soldat ◽  
Andrea Krueger ◽  
Amir A. Mahabadi ◽  
Iryna Dykun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Survival Rate ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients ◽  
Insulin Dependent ◽  
Artery Disease ◽  
One Year

An increasing number of patients with coronary artery disease are at high operative risk due to advanced age, severe comorbidities, complex coronary anatomy, and reduced ejection fraction. Consequently, these high-risk patients are often offered percutaneous coronary intervention (PCI) as an alternative to coronary artery bypass grafting (CABG). We aimed to investigate the outcome of patients with diabetes mellitus (DM) undergoing high-risk PCI. We analyzed consecutive patients undergoing high-risk PCI (period 01/2016–08/2018). In-hospital major adverse cardiac and cerebrovascular events (MACCEs), defined as in-hospital stroke, myocardial infarction and death, and the one-year incidence of death from any cause were assessed in patients with and without DM. There were 276 patients (age 70 years, 74% male) who underwent high-risk PCI. Eighty-six patients (31%) presented with DM (insulin-dependent DM: n = 24; non-insulin-dependent DM: n = 62). In-hospital MACCEs occurred in 9 patients (3%) with a non-significant higher rate in patients with DM (n = 5/86, 6% vs. n = 4/190 2%; p = 0.24). In patients without DM, the survival rate was insignificantly higher than in patients with DM (93.6% vs. 87.1%; p = 0.07). One-year survival was not significantly different in DM patients with more complex coronary artery disease (SYNTAX I-score ≤ 22: 89.3% vs. > 22: 84.5%; p = 0.51). In selected high-risk patients undergoing high-risk PCI, DM was not associated with an increased incidence of in-hospital MACCEs or a decreased one-year survival rate.

Early detection of coronary artery disease by 64-slice multidetector computed tomography in asymptomatic hypertensive high-risk patients

2009 ◽  
Vol 135 (3) ◽  
pp. 280-286 ◽  
Author(s):  
Carlo Gaudio ◽  
Francesca Mirabelli ◽  
Francesco Pelliccia ◽  
Marco Francone ◽  
Gaetano Tanzilli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Early Detection ◽  
Multidetector Computed Tomography ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease
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