Endarterectomy and graft replacement of severely calcified (porcelain) ascending aorta with coronary ostial involvement in a patient requiring aortic valve replacement
| Autor: | Hitoshi, Terada, Teruhisa, Kazui, Katsushi, Yamashita, Naoki, Washiyama, Kazuchika, Suzuki, Takayasu, Suzuki, Bashar, Abul Hasan Muhammad |
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| Rok vydání: | 2005 |
| Předmět: |
Heart Valve Prosthesis Implantation
Coronary Stenosis Calcinosis Aortic Valve Stenosis Endarterectomy Coronary Angiography Prosthesis Design Combined Modality Therapy Risk Assessment Severity of Illness Index Treatment Outcome Heart Valve Prosthesis Humans Female Coronary Artery Bypass Aorta Aged Follow-Up Studies |
| Zdroj: | Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 11(4) |
| ISSN: | 1341-1098 |
| Popis: | We report a successful aortic valve replacement within an extensively calcified (porcelain) aorta, involving the left coronary artery ostium. Clamping such an aorta can result in embolization, dissection, and mural laceration. A 72-year-old female presented with a severely calcified and stenotic aortic valve with a peak pressure gradient of 101 mmHg. Computed tomography demonstrated extensive calcification of the ascending aorta. Coronary angiogram showed a 50% ostial left coronary artery stenosis. Under deep hypothermic circulatory arrest, the aorta was transected at the proximal arch and distal graft anastomosis was performed. This was followed by endarterectomy of the porcelain ascending aorta and the left coronary ostium. Aortic valve replacement, proximal aortic graft anastomosis, and a coronary artery bypass grafting (CABG) with the left internal thoracic artery (LITA) anastomosed to the left anterior descending artery (LAD) were then performed in a sequential manner. |
| Databáze: | OpenAIRE |
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