The Annals of thoracic surgery
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Case Reports
Transcatheter aortic valve replacement for patients with aortic valve stenosis complicated with moyamoya disease.
Moyamoya disease (MMD) is a rare disease characterized by occlusive intracranial arteriopathy with formation of abnormal cerebrovascular collateral networks. Conventional cardiovascular surgical procedures using cardiopulmonary bypass for patients with MMD is challenging because low cerebral perfusion pressure and nonpulsatile (continuous) flow during cardiopulmonary bypass can cause severe cerebral ischemia. We successfully performed transcatheter aortic valve replacement in 3 women with severe aortic valve stenosis complicated with MMD. Transcatheter aortic valve replacement may be useful for patients with severe aortic valve stenosis complicated with severe cerebral ischemia, including MMD.
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Venoarterial extracorporeal membrane oxygenation is used for patients with refractory cardiopulmonary failure. Arterial cannulation by means of femoral arteries is fraught with potential complications. We present a technique for subclavian artery cannulation to provide a safe and durable means of venoarterial extracorporeal membrane oxygenation support.