scholarly journals Clinical case: aortic valve replacement with aortic root reconstruction and coronary artery bypass grafting in 73-yo obese female patient

2018 ◽  
Vol 9 (1) ◽  
pp. 71-75
Author(s):  
D. V. Borisov ◽  
A. S. Zotov ◽  
S. A. Vachev ◽  
A. V. Troitskiy ◽  
R. I. Khabazov
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Female Patient ◽  
Valve Replacement ◽  
Aortic Root ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Obese Female

Aortic valve replacement is the second most common cardiac surgery procedure. Prosthesis-patient size mismatch can increase the incidence of adverse events postoperatively, it also leads to increased left ventricular load. Some studies describe the higher mortality in this group of patients. It is also proved that patients with severe aortic stenosis usually have impaired platelet aggregation and low von Willebrand factor causing bleeding disorders. We report a case of successful aortic valve replacement and aortic root enlargement (Nicks technique) combined with coronary artery bypass grafting (left internal mammary artery to the left anterior descending artery) and left atrial appendage resection in 73-y.o. obese female patient. Postoperative course was uneventful.

scholarly journals Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aditya Eranki ◽  
Claudia Villanueva ◽  
Nicholas Collins ◽  
Peng Seah
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Ventricular Thrombus

Abstract Introduction Left ventricular (LV) thrombus is a complication of acute myocardial infarction and is associated with systemic thromboembolism. We describe a trans-aortic endoscopic approach to the removal of an LV thrombus in a patient undergoing concurrent coronary artery bypass grafting and aortic valve replacement. Case presentation A 47 year old male presented following an embolic middle cerebral artery stroke and underwent transthoracic echocardiography demonstrating a mobile LV thrombus. Additional investigation revealed a moderately stenosed bicispid aortic valve, two vessel coronary artery disease and ischemic cardiomyopathy. The patient underwent early surgery to reduce the risk of further embolic episodes. A trans-aortic approach was utilized with videoscopy and single shafted instrumentation to aide in removal of the thrombus. The patient then underwent aortic valve replacement and coronary artery bypass grafting. Conclusion We report an alternative technique for the removal of a left ventricular thrombus in a patient undergoing concurrent coronary and aortic valve surgery. The transaortic video-assisted approach provided excellent visualisation of the apex and near complete removal of the thrombus without damaging the surrounding trabeculae. The main benefit of this technique is sparing of LV tissue, thereby preserving left ventricular function.

Combined coronary artery bypass grafting and aortic valve replacement

2021 ◽  
pp. 451-454
Author(s):  
Christopher Lau ◽  
Leonard N. Girardi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Cardiac Procedures

Aortic valve replacement and/or coronary artery bypass grafting (CABG) have become the most common cardiac procedures as the population ages and life expectancy increases. In isolation, both CABG and aortic valve replacement are performed with excellent outcomes throughout the world with operative mortalities of 1–2%. Both procedures have seen significant advances in recent years. The combination of an aortic valve procedure and CABG adds increased complexity and risk, which must be accounted for during operative planning in order to mitigate as much of the increased risk as possible. Improvements in postoperative care, myocardial protection, and operative techniques for combined CABG and aortic valve replacement have resulted in an operative mortality of 0.8–6.4% in recent series.

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