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Off-Pump Coronary Artery Bypass Grafting and Transaortic Transcatheter Aortic Valve Replacement

Sophia L Dellis1, Adanna C Akujuo2, Edward V Bennett2

  • 1Albany Medical College, Albany Medical Center, Albany, New York.

Journal of Cardiac Surgery
|May 20, 2016
PubMed

Insights

Off-pump coronary artery bypass grafting and transcatheter aortic valve replacement effectively treated two patients with porcelain aortas. This combined approach is a viable option for high-risk patients with complex coronary artery disease and aortic stenosis.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Porcelain aorta presents a significant surgical challenge for aortic valve replacement and coronary artery bypass grafting.
  • High-risk patients with severe aortic stenosis and coronary artery disease often have comorbidities complicating traditional surgical approaches.

Observation:

  • Two patients with porcelain aortas and complex coronary lesions unsuitable for percutaneous coronary intervention were treated.
  • The patients had severe aortic stenosis and coronary artery disease, deemed high-risk for conventional surgery.

Findings:

  • Successful combined off-pump coronary artery bypass grafting (OPCABG) and transcatheter aortic valve replacement (TAVR) was achieved in both patients.
  • The procedures demonstrated the feasibility and effectiveness of this combined strategy in complex cases.

Implications:

  • Concomitant OPCABG and TAVR should be considered for carefully selected high-risk patients with porcelain aortas and complex coronary and aortic valve disease.
  • This approach offers a potential solution for patients who are not candidates for standard surgical interventions or percutaneous coronary intervention alone.

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