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Aortic valve replacement using balloon catheter for thoracic endovascular aortic repair to patient with calcified
In Sook Kim1, Joung Hun Byun, Byung Ha Yoo
1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Insights
A 79-year-old man with severe aortic calcification underwent successful aortic valve replacement using thoracic endovascular aortic repair, avoiding traditional open-heart surgery. This minimally invasive approach facilitated a swift recovery and discharge.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Severe aortic calcification can lead to significant hemodynamic compromise.
- Aortic stenosis necessitates intervention to relieve pressure gradients and improve cardiac function.
- Traditional aortic valve replacement involves cardiopulmonary bypass and aortic cross-clamping.
Observation:
- The patient presented with chest pain and dyspnea, indicative of cardiac compromise.
- Echocardiography revealed a reduced ejection fraction (31%) and a high mean pressure gradient (69.4 mmHg) across the aortic valve.
- Computed tomography identified severe calcification of the ascending aorta.
Findings:
- Successful aortic valve replacement was achieved using a thoracic endovascular aortic repair (TEVAR) balloon catheter.
- The procedure avoided the need for classic aortic cross-clamping and cardiopulmonary bypass.
- The patient experienced a favorable postoperative course.
Implications:
- Thoracic endovascular aortic repair offers a less invasive alternative for aortic valve replacement in select patients.
- This approach may reduce surgical trauma and potentially shorten recovery times.
- TEVAR represents an evolving strategy in managing complex aortic valve disease.
Abstract:
A 79-year-old man was admitted to Samsung Changwon Hospital due to chest pain and dyspnea. The ejection fraction was 31% and mean pressure gradient between the left ventricle and aorta was 69.4 mmHg on echocardiography. Chest computed tomography showed severe calcification of the ascending aorta. Aortic valve replacement was successfully performed using a thoracic endovascular aortic repair balloon catheter without classic aortic cross clamping. The patient was discharged on the eleventh postoperative day.