Aortic Valve Replacement for Patients with Functioning Internal Mammalian Artery Grafts

Area of Science:

• Cardiovascular Surgery
• Cardiac Anesthesia
• Thoracic Surgery

Background:

• Aortic valve replacement (AVR) in patients with a patent internal thoracic artery (ITA) graft is complex.
• Optimal surgical strategies for AVR with an existing ITA graft are debated.
• Preserving graft function during AVR is crucial for patient outcomes.

Observation:

• This study reports on five cases of AVR in patients with functioning ITA grafts.
• The procedure utilized continuous retrograde cardioplegia and moderate hypothermia.
• Crucially, the ITA graft was not clamped during the aortic valve replacement.

Findings:

• The described technique facilitates AVR in patients with patent ITA grafts.
• Continuous retrograde cardioplegia and moderate hypothermia were successfully employed.
• Avoiding ITA clamping appears feasible and safe within this approach.

Implications:

• This approach may offer a viable solution for managing complex AVR cases involving ITA grafts.
• Further research can validate this technique for broader clinical application.
• Improved surgical strategies can enhance outcomes for patients requiring AVR with prior ITA grafting.