Key result
Rescue CABG enables successful bypass weaning after coronary compromise during surgical aortic valve replacement.
Why the study?
Although surgical aortic valve replacement is generally straightforward, difficulty weaning from cardiopulmonary bypass due to compromised coronary flow and biventricular failure can occur and requires management strategies.
Case Report (n=1)
Concomitant CABG can be a necessary rescue strategy for patients experiencing compromised coronary flow and biventricular failure preventing weaning from CPB after SAVR.
Concomitant CABG may rescue CPB weaning failure after SAVR; single case leaves open need for systematic study of coronary complications.
Aortic valve replacement (AVR) remains the treatment of choice for severe aortic stenosis. Despite the growing number of transcatheter AVR (TAVR) in younger and intermediate-to-low-risk patients, surgical AVR (SAVR) is widely used and retains low operative mortality, low rate of complications, and predictable long-term valve durability. Although it is a straightforward procedure, on some occasions, a surgeon could face challenging situations, such as compromised coronary flow and an inability to wean the patient from cardiopulmonary bypass (CPB). Our patient required concomitant coronary artery bypass grafting to overcome biventricular failure and facilitate successful weaning from CPB.
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Korelidis et al. (2023) conducted a case report in Severe aortic stenosis (n=1). Surgical aortic valve replacement and concomitant coronary artery bypass grafting was evaluated on Successful weaning from cardiopulmonary bypass. In a 78-year-old female undergoing surgical aortic valve replacement, inability to wean from cardiopulmonary bypass due to compromised coronary flow was successfully managed with concomitant coronary artery bypass grafting.
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