scholarly journals Concomitant aortic valve replacement and retrosternal goitre resection via mini-sternotomy: a novel case

2020 ◽  
Vol 2020 (5) ◽  
Author(s):  
Rickesh B Karsan ◽  
Prakash Nanjaiah ◽  
John Hogan ◽  
Dheeraj Mehta ◽  
Michael Stetchman
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Aortic Arch ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Median Sternotomy ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Combined Procedure

Abstract Median sternotomy has been used to aide thyroidectomies demonstrating good outcomes; however no cases have been documented to show the use of mini-sternotomy to perform simultaneous thyroidectomy and valve surgery. We present a novel case of an 83-year-old woman with severe aortic stenosis and retrosternal goitre extending to the aortic arch deemed unsuitable for TAVI. Due to co-morbid status and anatomical position preventing routine thyroidectomy, we elected to perform a combined procedure to excise the goitre and perform an aortic valve replacement through a mini-J sternotomy, utilizing 3D-reconstructed imaging to plan our approach. This case shows that mini-sternotomy is a safe and effective method to perform concomitant thyroidectomy and aortic valve surgery.

Management of a Protruding Right Coronary Artery Stent during Aortic Valve Replacement for Aortic Stenosis

2012 ◽  
Vol 7 (3) ◽  
pp. 213-216 ◽  
Author(s):  
Nnamdi Nwaejike ◽  
Christopher Rozario ◽  
Franco Sogliani
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Medical Care ◽  
Valve Replacement ◽  
Coronary Intervention ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Percutaneous Coronary

We describe the successful management of a stent protruding from the right coronary ostium into the aortic root in the setting of aortic valve replacement for aortic stenosis. Due to advances in medical care more elderly patients present for aortic valve surgery after percutaneous coronary intervention. Therefore, with an aging population due to advances in medical care, more patients will present for aortic valve surgery after percutaneous coronary intervention. We suggest a degree of caution before valve deployment in transcatheter aortic valve intervention or during annular manipulation in patients undergoing traditional aortic valve replacement with coexisting patent proximal stents.

scholarly journals Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charbel Abi Khalil ◽  
Barbara Ignatiuk ◽  
Guliz Erdem ◽  
Hiam Chemaitelly ◽  
Fabio Barilli ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Randomized Clinical Trials ◽  
Severe Aortic Stenosis ◽  
Paravalvular Leak ◽  
Effective Orifice Area ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Heart Valve

AbstractTranscatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials that compared TAVR to sAVR for at least 2 years. The primary outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary outcomes were post-procedural and 2-year: effective orifice area (EOA), paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL). We identified 6 trials with a total of 7022 participants with severe aortic stenosis. TAVR was associated with 37% (95% CI [0.51–0.78) mean RR reduction of post-procedural PPM, a decrease that was not affected by the surgical risk at inclusion, neither by the transcatheter heart valve system. Postprocedural changes in gradient and EOA were also in favor of TAVR as there was a pooled mean difference decrease of 0.56 (95% CI [0.73–0.38]) in gradient and an increase of 0.47 (95% CI [0.38–0.56]) in EOA. Additionally, self-expandable valves were associated with a higher decrease in gradient than balloon ones (beta = 0.38; 95% CI [0.12–0.64]). However, TAVR was associated with a higher risk of moderate/severe PVL (pooled RR: 9.54, 95% CI [5.53–16.46]). All results were sustainable at 2 years.

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