Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting

Authors

  • Taira Yamamoto, PhD Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
  • Daisuke Endo, PhD Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
  • Hironobu Yamaoka, PhD Department of Cardiovascular Surgery, Edogawa Hospital, Tokyo, Japan
  • Akie Shimada, PhD Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
  • Satoshi Matsushita, PhD Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
  • Atsushi Amano, PhD Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan

DOI:

https://doi.org/10.1532/hsf.3535

Keywords:

Aortic valve replacement redo-cardiac surgery, Hemodialysis, Rapid-deployment aortic valve, Intuity system, saphenous vein graft

Abstract

Background: Aortic valve reoperation increases the risk of mortality and morbidity. The 2017 European Society of Cardiology guidelines for managing valvular heart disease with a previous heart surgery and intact bypass grafts consider patients with high surgical risk to be injury-prone during sternotomy. In high-risk patients with prior coronary artery bypass grafting, several authors have reported the noninferiority or superiority of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement; however, in Japan, TAVR cannot be performed for patients on hemodialysis. In this study, we report a case of successful implantation of the new rapid-deployment bioprosthesis in a 65-year-old Japanese man on dialysis with prior coronary artery bypass grafting.

Methods: The rapid-deployment aortic valve system has demonstrated excellent hemodynamic performance, durability, and safety. However, implantation requires specific training and the analysis of preoperative 3D computed tomographic imaging. The cineangiography revealed patency of all grafts, and the saphenous vein graft (SVG) had overlapped the planned aortotomy position. By avoiding the anastomotic part of the SVG, we could perform rapid-deployment aortic valve replacement efficiently even if the aortic incision was repositioned, and the incision was smaller than planned.

Results: We used the 23-mm Intuity valve without an additional stitch, and the cardiopulmonary bypass and aortic cross-clamp times were only 52 and 39 minutes, respectively.

Conclusion: This novel valve may be beneficial in complex combinational procedures for hemodialysis patients with prior coronary artery bypass grafting.

References

Ando T, Briasoulis A, Holmes AA, et al. 2016. Transcatheter aortic valve replacement versus surgical aortic valve replacement in patients with previous coronary artery bypass surgery: A systematic review and meta-analysis. Int J Cardiol 215:14-19.

Andreas M, Coti I, Rosenhek R, et al. 2019. Intermediate-term outcome of 500 consecutive rapid-deployment surgical aortic valve procedures. Eur J Cardiothorac Surg 55:527-33.

Baumgartner H, Falk V, Bax JJ, et al. 2017. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 38:2739-91.

Berretta P, Arzt S, Fiore A, et al. 2020. Trends of sutureless and rapid deployment valves: An 11-year experience from the Sutureless and Rapid Deployment International Registry. Eur J Cardiothorac Surg 58:1054-62.

Chan PG, Sultan I, Gleason TG, Navid F, Kilic A. 2019. Mechanical versus bioprosthetic valves in patients on dialysis. J Thorac Dis 11:1996-2005.

Conte JV, Gleason TG, Resar JR, et al. 2016. Transcatheter or surgical aortic valve replacement in patients with prior coronary artery bypass grafting. Ann Thorac Surg 101:72-9.

Coti I, Haberl T, Scherzer S, et al. 2020. Outcome of rapid deployment aortic valves: Long-term experience after 700 implants. Ann Cardiothorac Surg 9:314-21.

Greason KL, Mathew V, Suri RM, et al. 2014. Transcatheter versus surgical aortic valve replacement in patients with prior coronary artery bypass graft operation: A PARTNER trial subgroup analysis. Ann Thorac Surg 98:1-7.

Jegaden O, Lapeze J, Farhart F, de Gavigney G. 2012. Aortic valve stenosis after previous coronary bypass: Transcatheter valve implantation or aortic valve replacement? J Cardiothorac Surg 7:47-9.

Kocher AA, Laufer G, Haverich A, et al. 2013. One-year outcomes of the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial: A prospective multicenter study of rapid-deployment aortic valve replacement with the EDWARDS INTUITY Valve System. J Thorac Cardiovasc Surg 145:110-16.

Nakatsu T, Minakata K, Tanaka S, Minatoya K. 2019. PROGRESS-Kyoto Investigators. Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis. J Thorac Cardiovasc Surg 157:2177-86.

Published

2021-06-11

How to Cite

Yamamoto, T., Endo, D. ., Yamaoka , H., Shimada, A., Matsushita, S., & Amano, A. . (2021). Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting. The Heart Surgery Forum, 24(3), E530-E533. https://doi.org/10.1532/hsf.3535

Issue

Vol. 24 No. 3 (2021)

Section

Articles

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