Interventional Bridging Therapy for Radical Cardiac Surgery in a Patient Seemed to be Inoperable Due to Very Poor Left Ventricular Function: A Case Report

Authors

  • JeongA Lee Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Masahiro Tsutsui Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Nobuhiro Mochizuki Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Yuki Setogawa Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Fumitaka Suzuki Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Masahiko Narita Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Aina Hirofuji Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Shingo Kunioka Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Tomonori Shirasaka Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Natsuya Ishikawa Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan
  • Sayaka Yuzawa Department of Diagnostic Pathology, Asahikawa Medical University Hospital, 078-8510 Asahikawa, Hokkaido, Japan
  • Hiroyuki Kamiya Department of Cardiac Surgery, Asahikawa Medical University, 078-8510 Asahikawa, Hokkaido, Japan

DOI:

https://doi.org/10.59958/hsf.5779

Keywords:

bridge therapy, balloon aortic valvuloplasty, low cardiac function

Abstract

Cases that are inoperable owing to poor preoperative conditions are sometimes encountered. However, there are some cases that are led to radical treatment by performing bridge therapy. Here, we presented a case of a patient with complex cardiac disease in an inoperable state who underwent bridging therapy that led to successful surgical treatment. A 73-year-old male who received hemodialysis treatment and had severe aortic valve stenosis and coronary artery disease planned surgical treatment. However, he was deemed inoperable owing to his low cardiac function and hemodynamic instability. Therefore, to escape from a fatal condition, we first performed balloon aortic valvuloplasty and percutaneous coronary intervention as palliative procedures. Subsequently, his cardiac function and hemodynamic stability remarkably improved; therefore, after 1 month, we performed a successful radical surgical treatment. Even in inoperable patients, bridging therapy leading to radical treatment is possible.

References

Fukunaga H, Higashitani M, Tobaru T, Mahara K, Takanashi S, Takayama M. Emergent balloon aortic valvuloplasty as a bridge to transcatheter aortic valve implantation with marked risk reduction of perioperative and postoperative mortality. Cardiovascular Intervention and Therapeutics. 2016; 31: 151–155.

Yanagisawa H, Saito N, Imai M, Minakata K, Fujita T, Watanabe S, et al. Successful balloon aortic valvuloplasty as a bridge therapy to transcatheter aortic valve implantation during the proctoring period. Journal of Cardiology Cases. 2015; 12: 113–116.

Nwaejike N, Mills K, Stables R, Field M. Balloon aortic valvuloplasty as a bridge to aortic valve surgery for severe aortic stenosis. Interactive Cardiovascular and Thoracic Surgery. 2015; 20: 429–435.

Otto CM, Mickel MC, Kennedy JW, Alderman EL, Bashore TM, Block PC, et al. Three-year outcome after balloon aortic valvuloplasty. Insights into prognosis of valvular aortic stenosis. Circulation. 1994; 89: 642–650.

Percutaneous balloon aortic valvuloplasty. Acute and 30-day follow-up results in 674 patients from the NHLBI Balloon Valvuloplasty Registry. Circulation. 1991; 84: 2383–2397.

Kapadia S, Stewart WJ, Anderson WN, Babaliaros V, Feldman T, Cohen DJ, et al. Outcomes of inoperable symptomatic aortic stenosis patients not undergoing aortic valve replacement: insight into the impact of balloon aortic valvuloplasty from the PARTNER trial (Placement of AoRtic TraNscathetER Valve trial). JACC. Cardiovascular Interventions. 2015; 8: 324–333.

Ben-Dor I, Pichard AD, Satler LF, Goldstein SA, Syed AI, Gaglia MA Jr, et al. Complications and outcome of balloon aortic valvuloplasty in high-risk or inoperable patients. JACC. Cardiovascular Interventions. 2010; 3: 1150–1156.

Sandhu K, Krishnamoorthy S, Afif A, Nolan J, Gunning MG. Balloon aortic valvuloplasty in contemporary practice. Journal of Interventional Cardiology. 2017; 30: 212–216.

Rigatelli G, Dell'Avvocata F, Conte L, Lanza D, Giatti S, Del Santo P, et al. Modified balloon aortic valvuloplasty in fragile symptomatic patients unsuitable for both surgical and percutaneous valve replacement. Cardiovascular Revascularization Medicine. 2018; 19: 444–447.

Ford TJ, Nguyen K, Brassil J, Kushwaha V, Friedman D, Allan R, et al. Balloon Aortic Valvuloplasty in the Transcatheter Valve Era: Single Centre Indications and Early Safety Data in a High Risk Population. Heart, Lung & Circulation. 2018; 27: 595–600.

Kleczynski P, Kulbat A, Brzychczy P, Dziewierz A, Trebacz J, Stapor M, et al. Balloon Aortic Valvuloplasty for Severe Aortic Stenosis as Rescue or Bridge Therapy. Journal of Clinical Medicine. 2021; 10: 4657.

Reynolds C, Tazelaar HD, Edwards WD. Calcified amorphous tumor of the heart (cardiac CAT). Human Pathology. 1997; 28: 601–606.

de Hemptinne Q, de Cannière D, Vandenbossche JL, Unger P. Cardiac calcified amorphous tumor: A systematic review of the literature. International Journal of Cardiology. Heart & Vasculature. 2015; 7: 1–5.

Published

2023-11-06

How to Cite

Lee, J., Tsutsui, M., Mochizuki, N., Setogawa, Y., Suzuki, F., Narita, M., Hirofuji, A., Kunioka, S., Shirasaka, T., Ishikawa, N., Yuzawa, S., & Kamiya, H. (2023). Interventional Bridging Therapy for Radical Cardiac Surgery in a Patient Seemed to be Inoperable Due to Very Poor Left Ventricular Function: A Case Report. The Heart Surgery Forum, 26(6), E676-E679. https://doi.org/10.59958/hsf.5779

Issue

Section

Case Report