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One-stage surgical management for advanced dilated cardiomyopathy combined with aortic sinus aneurysm: a case report
Wenliu Xu1, Chaojie Wang1, Zengxiao Zou1
1Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Insights
Left ventricular assist device (LVAD) implantation combined with aortic surgery offers a viable treatment for advanced heart failure patients with complex aortic conditions. This combined approach can improve outcomes for carefully selected individuals.
Area of Science:
- Cardiovascular Surgery
- Heart Failure Management
- Medical Devices
Background:
- Left ventricular assist device (LVAD) implantation is a key therapy for advanced heart failure, enhancing survival and quality of life.
- Co-existing cardiac conditions like valvular regurgitation and coronary heart disease are frequent in LVAD candidates.
- Surgical interventions for heart failure alongside aortic disease are infrequently documented.
Introduction:
Left ventricular assist device (LVAD) implantation is a highly effective procedure for the management of selected advanced heart failure patients, prolonging patient life and improving quality. Additional cardiac pathologies, especially valvular regurgitation or coronary heart disease, are common in LVAD recipients, whereas reports on the surgical management of heart failure combined with aortic disease are rare.
Case Presentation:
We present a case of a 60-year-old patient with an aortic sinus aneurysm, aortic regurgitation, and end-stage heart failure. LVAD implantation was performed concomitantly with the Bentall procedure and Cabrol shunt technique. The patient was discharged uneventfully on postoperative day 26. This suggests that combining LVAD implantation with additional cardiovascular procedures could be an alternative strategy for patients with complex heart failure conditions.
Conclusion:
LVAD implantation combined with additional aortic surgery can be a feasible alternative with acceptable risk, especially for patients who have elected to pursue LVAD as destination therapy. Successful outcomes require adequate preoperative evaluation, experienced cardiac surgeons, and close postoperative care.
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