| Autor: |
Owais T; Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany.; Department of Cardiothoracic Surgery, Cairo University, Giza P.O. Box 12613, Egypt., Bisht O; Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany., Polat E; Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany., Abdelmoteleb N; Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany., El Garhy M; Department of Cardiology, Helios Clinic Erfurt, 99089 Erfurt, Germany., Lauten P; Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany., Kuntze T; Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany., Girdauskas E; Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany. |
| Abstrakt: |
In this bicentric study, we report the outcomes of combined transcatheter aortic valve replacement combined with minimally invasive mitral valve surgery. We included a cohort of six patients (79.6 ± 3.2 years, 83% women) with high-risk profiles and deemed to be non-operable with combined mitral and aortic valvular disease. All patients had unsuitable anatomies for transcatheter mitral valve edge-to-edge repair (TEER). Moreover, most of the patients (5/6) suffered a combined aortic valve lesion, which complicates the efficiency of cardioplegia in the case of CBP through minimally invasive incisions. The first stage was implanting a TAVI valve to achieve aortic valve competency and hence facilitate the infusion of cardioplegia after clamping the aorta during endoscopic mitral valve surgery. After one week, we performed the minimally invasive mitral valve repair. Most patients (n = 5; 83%) underwent successful endoscopic mitral valve repair. Intraoperatively, the mean ischemic time was 42 min, and the total bypass time was 72 min. Postoperatively, the mean intubation time was 0 h. Postoperative complications included reoperation for bleeding in one patient (16.7%) and a new heart block requiring pacemaker implantation in one patient (16.7%). There was neither in-hospital mortality nor 1-year mortality. |
