Key result
TAV-in-TAV with CABG maintains graft patency and clinical stability through 4 years in high-risk anatomy.
Why the study?
High risk of coronary occlusion during TAV-in-TAV presents a clinical challenge requiring alternative management strategies.
Does concomitant CABG prevent coronary obstruction in patients undergoing TAV-in-TAV who are at high risk of occlusion?
Case Report (n=1)
No
Does concomitant CABG prevent coronary obstruction in patients undergoing TAV-in-TAV who are at high risk of occlusion?
Concomitant CABG is a feasible option to prevent coronary obstruction in patients undergoing TAV-in-TAV who are at high risk for this complication.
Answers are grounded in this paper and cite their sources.
Concomitant CABG may be feasible in select high-risk TAV-in-TAV; hypothesis-generating and should not yet change practice.
A 94-year-old man who underwent transcatheter aortic valve (TAV) replacement 6 years ago was admitted because of exertional dyspnea. Transthoracic echocardiography revealed severe aortic regurgitation owing to TAV dysfunction. The patient was considered to have a high risk of occlusion of the sinus of Valsalva during TAV-in-TAV. Therefore, we performed TAV-in-TAV concomitant with coronary artery bypass grafting (CABG). The postoperative course was uneventful, and computed tomography 9 months later revealed patency of both the grafts. Concomitant CABG could be considered as one of the options in patients with a high risk of coronary occlusion during TAV-in-TAV.
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Sakakibara et al. (2022) conducted a case report in Severe aortic regurgitation due to TAV dysfunction (n=1). TAV-in-TAV concomitant with CABG was evaluated on Procedural success and graft patency. TAV-in-TAV concomitant with CABG was successfully performed in a patient at high risk of coronary obstruction, maintaining good graft patency and clinical status at 4 years.
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