Key result
Staged left subclavian artery stenting followed by four-vessel on-pump CABG and ascending aortic replacement was utilized to manage a single patient with multivessel CAD and a porcelain aorta.
Case Report (n=1)
A staged approach combining subclavian stenting with subsequent CABG and ascending aortic replacement provides a viable strategy for patients with multivessel CAD and a porcelain aorta.
Should not change practice from one case; leaves open the role of staged hybrid revascularization in porcelain aorta.
We report a complex case of multivessel CAD in a patient with a porcelain aorta and high-grade left subclavian artery stenosis. Utilizing a staged left subclavian artery stent placement with a next-day plan for a four-vessel, on-pump CABG and ascending aortic replacement, this case highlights an organized approach to diagnosing and dealing with a heavily calcified aorta while describing a stepwise algorithm to deal with aortic calcifications prior to initiating cardiac surgery.
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Adesanya et al. (2014) conducted a case report in Multivessel CAD with porcelain aorta and high-grade left subclavian artery stenosis (n=1). Staged left subclavian artery stent placement and four-vessel on-pump CABG with ascending aortic replacement was evaluated. Staged left subclavian artery stenting followed by four-vessel on-pump CABG and ascending aortic replacement was utilized to manage a single patient with multivessel CAD and a porcelain aorta.
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