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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Aortic root replacement in severe left ventricular dysfunction: The added value of beating-heart surgery
Berta Ganizada1,2, Samuel Heuts1, Colin Willems1
1Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands.
Journal of Cardiac Surgery
|September 1, 2022
Summary
This study presents a beating-heart surgical technique for aortic root replacement and coronary bypass grafting in high-risk patients. This approach minimizes risks associated with cardioplegic arrest and preserves cardiac function.
Area of Science:
- Cardiac Surgery
- Cardiovascular Research
- Surgical Innovation
Background:
- Cardioplegic arrest poses risks in complex cardiac surgeries, particularly for patients with severe left ventricular dysfunction.
- Alternative strategies are needed to mitigate risks and improve outcomes in high-risk cardiac surgical patients.
Purpose of the Study:
- To detail a surgical strategy for beating-heart aortic root replacement with concomitant coronary bypass grafting.
- To present a technique for patients deemed inoperable due to severe left ventricular dysfunction.
Main Methods:
- Utilized cardiopulmonary bypass (CPB) to facilitate beating-heart bypass surgery.
- Developed a technique to selectively connect bypass grafts to CPB, preserving coronary flow during aortic root replacement on a beating, perfused heart.
Main Results:
- Successfully performed complex aortic root replacement on a beating heart, preserving postoperative cardiac function.
- Minimized risks associated with cardioplegic arrest and avoided potential need for long-term extracorporeal membrane oxygenation.
Conclusions:
- Beating-heart aortic root replacement with CPB support is a viable strategy for high-risk patients.
- Careful attention to coronary perfusion, temperature management, and air embolism prevention is crucial for successful outcomes.
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