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Aortic coarctation, aortic valvular stenosis, and coronary artery disease: combined one-stage surgical therapy
S Bartoccioni1, C Giombolini, P Fiaschini
1Division of Cardiac Surgery, Ospedale R. Silvestrini, Azienda Ospedaliera di Perugia, Italy.
Insights
Simultaneous severe aortic coarctation and aortic valve disease, alongside ischemic cardiomyopathy, were successfully managed with a single-stage surgery. This approach corrected all conditions, restoring normal blood pressure and eliminating myocardial ischemia.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Defects
- Acquired Heart Disease
Background:
- Simultaneous severe coarctation of the descending aorta and severe aortic valve disease is a rare clinical presentation.
- Ischemic cardiomyopathy can coexist with these aortic pathologies, complicating management.
Observation:
- A case involving the simultaneous association of aortic coarctation, aortic valve disease, and ischemic cardiomyopathy is presented.
- A one-stage surgical approach was employed for the comprehensive correction of all identified pathologies.
Findings:
- The surgical procedure involved aortic valve replacement and myocardial revascularization.
- Coarctation of the aorta was successfully addressed using a prosthetic graft connecting the ascending and abdominal aorta.
- Post-operative assessment revealed no evidence of myocardial ischemia during exercise testing and normalized blood pressure.
Implications:
- This study demonstrates the feasibility and effectiveness of a one-stage surgical strategy for complex aortic and cardiac conditions.
- The findings suggest that combined surgical correction can lead to favorable long-term outcomes, including improved cardiac function and hemodynamics.
- This approach offers a potentially less invasive and more efficient treatment option for patients with multiple, severe cardiovascular abnormalities.
Abstract:
The presentation of simultaneous severe coarctation of the descending aorta and severe aortic valve disease is uncommon. We describe the management of simultaneous association of aortic coarctation, aortic valve disease, and ischemic cardiomyopathy and describe a one-stage surgical approach for the correction of all pathologies. After performing the aortic valve replacement and myocardial revascularization, coarctation was solved by means of a prosthesis between the ascending aorta and the abdominal aorta. There were no evidence of myocardial ischemia during exercise testing and the blood pressure is normal.