• The heart surgery forum · Feb 2011

    Case Reports

    Combined transapical aortic valve replacement and minimally invasive direct coronary bypass grafting--a new concept for selected high-risk patients.

    • Fritz Mellert, Johannes Breuer, Chris Probst, Armin Welz, and Wolfgang Schiller.
    • Department of Cardiac Surgery, University of Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany. fritz.mellert@uni-bonn.de
    • Heart Surg Forum. 2011 Feb 1;14(1):E61-3.

    BackgroundTranscatheter aortic valve implantation and minimally invasive direct coronary artery bypass (MIDCAB) procedures are both off-pump treatment options for a subset of higher-risk patients. We present a new, minimally invasive surgical concept involving combining the procedures and performing them through the same thoracic access in a patient with a vascular disorder.Case ReportWe report on a 78-year-old patient with symptomatic calcified aortic stenosis and a critical lesion of the left anterior descending coronary artery. In addition, Rendu-Osler-Weber disease was diagnosed. He was successfully treated with combined off-pump transapical, transcatheter aortic valve implantation and MIDCAB grafting. The initial postoperative recovery was good; however, the patient died 3 months postoperatively from septic complications.ConclusionThis combined procedure performed through the same anterolateral incision was technically feasible and may be a promising, minimally invasive approach for selected patients.

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