Journal of cardiac surgery
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Transcatheter aortic valve implantation has been shown to be an effective treatment for severe aortic stenosis in high-risk surgical patients. Many of these patients have significant coexisting coronary artery disease. We report the first case of combined off-pump transapical aortic valve implantation and minimally invasive direct coronary artery bypass via a left mini-thoracotomy in an 82-year-old man with significant comorbidities. This combined procedure is technically feasible and can be performed safely in selected patients with aortic stenosis and left anterior descending artery lesion that is not suitable for percutaneous intervention.
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The impact of the grafting techniques (individual or sequential grafts) on the graft patency of off-pump coronary artery bypass grafting (OPCAB) has not been reported. The mid-term patency rates for individual and sequential saphenous vein grafts (SVGs) as coronary bypass conduits of OPCAB were compared. ⋯ The mid-term patency of a sequential SVG conduit after OPCAB is excellent and generally superior to that of an individual one.
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We present a case of a transaortic mitral valve repair in double valve infective endocarditis. Through a conventional oblique aortotomy, the aneurysmal part of the anterior leaflet of the mitral valve was excised, an artificial neo chorda was implanted, and the aortic valve was replaced.
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A 55-year-old woman underwent elective mitral valve replacement due to severe rheumatic mitral valve stenosis. After valve replacement with a mechanical prosthesis, the patient failed to wean from the cardiopulmonary bypass. ⋯ Peripheral emboli are a known complication in patients undergoing mitral valve surgery for rheumatic mitral stenosis. In this report, we describe the case of a patient who sustained an intraoperative coronary embolus during a mitral valve replacement for rheumatic mitral stenosis.
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A 60-year-old female presented with a two-year history of exertional chest pain and progressive dyspnea. Resection of a cardiac hemangioma arising from the area of the bifurcation of the left anterior descending and circumflex coronary arteries resulted in complete resolution of her symptoms. The symptoms were likely caused by coronary steal.