scholarly journals Perceval S and Coronary Artery Bypass Grafting, Contradiction or Full Harmony?

2016 ◽  
Vol 1 (1) ◽  
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 ◽  
Sutureless Bioprostheses

Background / Study Objective: Coronary artery disease is very common in patients who are referred to aortic valve replacement. Concomitant coronary artery bypass grafting (CABG) procedure does not necessarily contradict with the use of last generation sutureless bioprostheses, but, publications about this combined approach are very limited. The objective of this study is to describe the results of aortic valve replacement plus CABG using Perceval S aortic sutureless bioprostheses in our Center. Methods: From our database we retrospectively described the outcomes of 42 patients who underwent aortic valve replacement with a last generation sutureless bioprostheses (Perceval S) plus CABG at the same procedure. We used a combination of arterials (left internal mammary artery (LIMA), right internal mammary artery (RIMA) and radial artery) and saphenous vein for the coronary artery bypass grafting. Most of the patients received 1 bypass (range: 1-3). Mean age: 78,19 ± 5,1. Male 64,3%, female 35,7%. Cardiovascular risk factors: Hypertension 97,6%; Diabetes 38,1%, Dyslipidemia 69%, peripheral vascular disease 38,2%, prior stroke 9,5%, chronic renal failure 40,5%, obstructive pulmonary disease 21,4% of the patients. Mean Logistic EuroScoreI/II: 16,68/10,73% (expected mortality). Results and Conclusions: Excellent results were achieved in patients undergoing aortic valve replacement with Perceval S sutureless bioprostheses and concomitant coronary artery bypass grafting. Although high aortotomy is needed for Perceval S implantation, is possible to perform proximal anastomosis for saphenous grafts properly. Perceval S is a feasible alternative for patients with aortic valve stenosis and coronary artery disease, with shorter cross-clamp and extracorporeal circulation times and low rate of complications.

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.

Concurrent Minimally Invasive Aortic Valve Replacement and Coronary Artery Bypass via Limited Right Anterior Thoracotomy

2015 ◽  
Vol 10 (4) ◽  
pp. 273-275
Author(s):  
Clifton T. P. Lewis ◽  
Richard L. Stephens ◽  
Jennifer L. Cline ◽  
Charles M. Tyndal
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

An 89-year-old man and an 80-year-old woman were treated surgically for critical aortic stenosis secondary to senile calcific aortic disease and high-grade calcified lesions in the ostium of the right coronary artery. Minimally invasive aortic valve replacement and concurrent coronary artery bypass grafting were performed concurrently through a 5-cm right anterior thoracotomy in the second intercostal space. Surgery was uncomplicated in both cases, with no adverse events. Both patients were alive and well at midterm follow-up. Concurrent minimally invasive aortic valve replacement and coronary artery bypass grafting can be performed successfully through a limited right anterior thoracotomy.

scholarly journals Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting

2021 ◽  
Vol 24 (3) ◽  
pp. E530-E533
Author(s):  
Taira Yamamoto ◽  
Daisuke Endo ◽  
Hironobu Yamaoka ◽  
Akie Shimada ◽  
Satoshi Matsushita ◽  
...  
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 ◽  
Rapid Deployment

Background: Aortic valve reoperation increases the risk of mortality and morbidity. The 2017 European Society of Cardiology guidelines for managing valvular heart disease with a previous heart surgery and intact bypass grafts consider patients with high surgical risk to be injury-prone during sternotomy. In high-risk patients with prior coronary artery bypass grafting, several authors have reported the noninferiority or superiority of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement; however, in Japan, TAVR cannot be performed for patients on hemodialysis. In this study, we report a case of successful implantation of the new rapid-deployment bioprosthesis in a 65-year-old Japanese man on dialysis with prior coronary artery bypass grafting. Methods: The rapid-deployment aortic valve system has demonstrated excellent hemodynamic performance, durability, and safety. However, implantation requires specific training and the analysis of preoperative 3D computed tomographic imaging. The cineangiography revealed patency of all grafts, and the saphenous vein graft (SVG) had overlapped the planned aortotomy position. By avoiding the anastomotic part of the SVG, we could perform rapid-deployment aortic valve replacement efficiently even if the aortic incision was repositioned, and the incision was smaller than planned. Results: We used the 23-mm Intuity valve without an additional stitch, and the cardiopulmonary bypass and aortic cross-clamp times were only 52 and 39 minutes, respectively. Conclusion: This novel valve may be beneficial in complex combinational procedures for hemodialysis patients with prior coronary artery bypass grafting.

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