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Aortic valve replacement through the transected aorta in a patient with aortic stenosis and a calcified ascending
T Watanabe1, Y Shimazaki, S Kuraoka
1Second Department of Surgery, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-2331, Japan.
Insights
This study presents a surgical technique for aortic valve replacement in patients with severe aortic calcification. The transected aorta approach offers a viable alternative for complex aortic valve stenosis cases.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Valve Surgery
Background:
- Aortic valve stenosis (AVS) and ascending aorta calcification pose surgical challenges.
- Traditional aortic valve replacement (AVR) may be complicated by porcelain aorta.
- Coronary artery disease often coexists with severe aortic valve disease.
Observation:
- A novel surgical approach involving transecting the aorta was utilized for AVR.
- A 19 mm St. Jude Medical prosthetic valve was implanted.
- Aortic cross-clamping was performed distal to the calcified annulus in a non-calcified segment.
Findings:
- The surgical procedure was successfully completed.
- No neurological deficits were observed post-operatively.
- This technique is effective for aortic valve replacement in patients with porcelain aorta.
Implications:
- Transected aorta AVR is a potential alternative for selected patients with porcelain aortas.
- This approach may improve outcomes in complex aortic valve stenosis cases.
- Further studies are warranted to evaluate long-term efficacy and safety.
Abstract:
This report describes a surgical approach of aortic valve replacement in a patient with a calcified ascending aorta, calcified aortic valve stenosis and coronary artery disease. The aortic valve was replaced with a 19 mm St. Jude Medical prosthetic valve through the transected aorta while the distal ascending aorta was cross-clamped at a narrow but not calcified band approximately 4.5 cm distal to the aortic anulus. These procedures were successfully done and no neurological deficit was found after surgery. The aortic valve replacement through the transected aorta may be one of the alternatives in selected patients with porcelain aortas and calcified aortic valves.