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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Related Experiment Video

Updated: Jul 16, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

[Apico-aortic conduit for severe aortic stenosis in elderly].

T Takemura1, Y Shimamura, M Sakaguchi

  • 1Department of Cardiovascular Surgery, National Nagano Hospital, Ueda, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 16, 2003
PubMed
Summary

An 84-year-old woman with severe aortic stenosis and heart failure underwent a successful apico-aortic conduit bypass. This procedure offers a viable option for elderly patients unsuitable for traditional valve replacement.

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Last Updated: Jul 16, 2026

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Published on: October 20, 2023

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Severe aortic stenosis poses significant risks, especially in elderly patients with comorbidities.
  • Conventional aortic valve replacement may not be suitable for all patients due to age and anatomical challenges.
  • This case highlights the management of a complex patient with end-stage aortic stenosis, complete atrio-ventricular block, and respiratory insufficiency.

Observation:

  • An 84-year-old female presented with symptoms refractory to pacemaker implantation for complete atrio-ventricular block.
  • Echocardiography revealed a small aortic annulus and severe calcific aortic stenosis with a high transvalvular gradient (100 mmHg).
  • The patient's condition rapidly deteriorated, leading to hypotension and acute renal failure, necessitating emergency intervention.

Findings:

  • An emergency apico-aortic conduit bypass was successfully performed using a bioprosthetic valved conduit.
  • The procedure involved anastomosing the conduit to the left ventricle apex and the descending thoracic aorta.
  • The patient was discharged on postoperative day 57 without complications, despite requiring temporary hemodialysis.

Implications:

  • Apico-aortic conduit bypass can be an effective alternative for high-risk elderly patients with severe aortic stenosis.
  • This surgical approach may offer a favorable outcome when conventional valve replacement is contraindicated.
  • The case underscores the importance of considering alternative surgical strategies for complex cardiovascular conditions in the elderly.