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[Adult apico-aortic shunts. A case followed for 6 years]
P Paule1, J Quilici, T Cuisset
1Département de cardiologie, Centre hospitalier universitaire de la Timone, Marseille. Philippe.PAULE@wanadoo.fr
Archives Des Maladies Du Coeur Et Des Vaisseaux
|November 22, 2005
Summary
An apico-aortic shunt effectively reduces aortic pressure gradients in severe stenosis patients unsuitable for valve replacement. This uncommon procedure proved efficient long-term in a complex case, confirming its value.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Symptomatic severe aortic stenosis often requires intervention.
- An apico-aortic shunt is an alternative when valvular replacement is contraindicated due to anatomical constraints.
Observation:
- A case report details an apico-aortic shunt in a patient with prior coronary artery bypass grafting using bilateral internal mammary arteries and severe ascending aorta calcification.
- The patient underwent this uncommon procedure due to contraindications for standard valvular replacement.
Findings:
- Angio-haemodynamic assessment and MRI at 3 and 5 years post-procedure confirmed the shunt's sustained efficiency.
- The procedure successfully reduced the aortic transvalvular pressure gradient.
Implications:
- The apico-aortic shunt is a valuable, albeit uncommon, therapeutic option for select patients with severe aortic stenosis.
- This case and literature review support the efficacy of apico-aortic shunts in complex surgical scenarios.