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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Transapical aortic valve replacement and concomitant coronary bypass grafting in on-pump beating fashion: a case

Shougo Takahashi1, Kentaro Shirakura1, Masahiro Tsutsui1

  • 1Department of Cardiac Surgery, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.

Journal of Surgical Case Reports
|March 10, 2025
PubMed

Insights

This case study details a successful on-pump beating heart procedure combining transapical transcatheter aortic valve replacement and coronary artery bypass grafting in an elderly patient with complex cardiovascular conditions.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Severe aortic valve stenosis and complex coronary artery disease pose significant surgical challenges.
  • Porcelain aorta and prior abdominal aortic replacement increase procedural risks.

Observation:

  • An elderly female patient presented with severe aortic valve stenosis and severe calcified coronary artery disease.
  • The patient had a history of abdominal aortic replacement and a porcelain aorta.

Findings:

  • Successful simultaneous transapical transcatheter aortic valve replacement (TAVR) and coronary artery bypass grafting (CABG) were performed.
  • The complex procedure was executed in an on-pump beating fashion, avoiding cardioplegic arrest.

Implications:

  • This case demonstrates the feasibility of combined on-pump beating TAVR and CABG in high-risk patients.
  • Such combined approaches may offer a viable solution for patients with extensive cardiovascular disease.
  • Further research is warranted to evaluate the long-term outcomes of this combined surgical strategy.

Keywords:
coronary artery bypass graftingon-pumptranscatheter aortic valve replacement

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