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Updated: Jun 7, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

11.6K

Integrated approach to aortic valve replacement, coronary intervention, and aortic aneurysm in severe LV dysfunction:

Vikas Kilaru1, Mena Louis2, Nathaniel Grabill2

  • 1Northeast Georgia Medical Center, Internal Medicine Department, United States of America; 743 Spring St., Gainesville, GA 30501, United States of America.

International Journal of Surgery Case Reports
|November 9, 2024
PubMed

Insights

Minimally invasive transcatheter valve replacement and coronary intervention offer a safer alternative for high-risk patients with complex cardiac conditions, including severe aortic stenosis and coronary artery disease.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Managing complex cardiac conditions like severe aortic stenosis, coronary artery disease, aortic aneurysm, and left ventricular dysfunction presents significant challenges.
  • Traditional treatments often involve highly invasive open-heart surgery, associated with increased risks and potential need for mechanical circulatory support.

Observation:

  • A 53-year-old patient with no significant past medical history presented with progressive exertional dyspnea.
  • The patient exhibited mixed aortic valve disease (severe aortic regurgitation, moderate aortic stenosis), coronary artery disease, and left ventricular dysfunction.
  • The patient was deemed high risk for conventional open-heart surgery due to severely reduced ejection fraction and anticipated need for prolonged cardiopulmonary bypass (CPB) and mechanical support.

Findings:

  • A less invasive approach involving transcatheter valve replacement and coronary intervention was successfully employed.
  • This strategy effectively avoided the risks associated with traditional open-heart surgery.

Implications:

  • The minimally invasive approach significantly improved cardiac function and aneurysm stability.
  • This case highlights the potential of transcatheter interventions in managing complex cardiac disease in high-risk patients.
  • Demonstrates a shift towards less invasive strategies in advanced cardiac care.
Abstract

Keywords:
Aortic aneurysmCase reportCoronary artery diseaseLeft ventricular dysfunctionPercutaneous coronary interventionTranscatheter aortic valve replacement

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