We report on simultaneous off-pump coronary artery bypass grafting to the left anterior descending artery, modified transapical aortic valve implantation, and stenting of the circumflex and right coronary arteries in an 84-year-old patient. The poly-morbid patient with a logistic EuroSCORE of 85% experienced recent myocardial infarction; the left ventricular ejection fraction was reduced to 20%. Postoperative recovery was fast and short. The strategy described is the next logical step in broadening the indication for transcatheter aortic valve interventions.
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2.
Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS); European Association for Percutaneous Cardiovascular Interventions (EAPCI), KolhP., WijnsW., DanchinN.Guidelines on myocardial revascularization. Eur J Cardiothorac Surg.2010; 38: S1–S52.
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PasicM., UnbehaunA., DreysseS.Transapical aortic valve implantation in 175 consecutive patients, excellent outcome in very high-risk patients. J Am Coll Cardiol.2010; 56: 813–820.
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PasicM., DreysseS., DrewsT.Improved technique of transapical aortic valve implantation: “the Berlin addition.”Ann Thorac Surg.2010; 89: 2058–2060.
