RESUMEN
We sought to demonstrate the effectiveness of off-pump coronary artery bypass grafting and transcatheter aortic valve replacement in two patients with porcelain aortas and lesions that could not be optimally treated with percutaneous coronary intervention. Patients with aortic stenosis and coronary artery disease who are too high-risk for conventional surgical aortic valve replacement and coronary artery bypass grafting due to comorbidities and porcelain aorta, and who do not have the appropriate anatomy for percutaneous coronary intervention should be considered for concomitant transcatheter aortic valve replacement and off-pump coronary artery bypass grafting. doi: 10.1111/jocs.12762 (J Card Surg 2016;31:435-438).
Asunto(s)
Estenosis de la Válvula Aórtica/complicaciones , Estenosis de la Válvula Aórtica/cirugía , Puente de Arteria Coronaria Off-Pump/métodos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/cirugía , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Anciano , Contraindicaciones , Femenino , Humanos , Masculino , Intervención Coronaria Percutánea , Resultado del TratamientoAsunto(s)
Remoción de Dispositivos/métodos , Falla de Equipo , Defectos del Tabique Interatrial/cirugía , Dispositivo Oclusor Septal/efectos adversos , Choque Cardiogénico/etiología , Obstrucción del Flujo Ventricular Externo/etiología , Ecocardiografía Transesofágica , Femenino , Ventrículos Cardíacos , Humanos , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico por imagen , Derrame Pericárdico/etiología , Obstrucción del Flujo Ventricular Externo/diagnóstico por imagenRESUMEN
A 68-year-old female with moderate to severe aortic stenosis and severe mitral stenosis, deemed too high risk for surgery (STS mortality risk = 12.3%) with a porcelain aorta, was successfully treated with a transcatheter aortic and mitral valve implantation (TAMVI) via a transapical approach. A 23 mm Sapien valve (Edwards Lifesciences, Irvine, CA, USA) was placed in the aortic position and a 29 mm inverted Sapien valve (Edwards Lifesciences) in the mitral position.