PMID: 16613147Apr 15, 2006Paper

Apicoaortic conduit insertion for elderly patients with acquired aortic stenosis and small aortic annulus

Kyobu geka. The Japanese journal of thoracic surgery
T Takemura, Y Tsuda

Abstract

Patients with critical aortic stenosis, a heavily calcified aorta, and a small aortic annulus are at an increasing risk of complications during a conventional aortic valve replacement (AVR) procedure. Insertion of an apicoaortic conduit (AAC) can be an alternative to AVR in such situations. This study is a review of our experiences with AAC in elderly patients with acquired aortic stenosis. From 2001 to 2005, 7 elderly patients (mean age of 81 : range 74 to 87) underwent an AAC insertion for severe symptomatic aortic stenosis with a small aortic annulus (mean annulus size 17.9 mm). Preoperatively, all were symptomatic, with 4 rated as New York Heart Association (NYHA) functional class IV, 2 as class III, and 1 as class II. In addition, 3 patients had severe congestive heart failure with mechanical ventilation and received a high dose administration of catecholamine, and 1 had undergone coronary artery bypass grafting (CABG) previously. The AAC insertions were performed under a cardiopulmonary bypass through a left thoracotomy in 6 patients, while 1 patient underwent the procedure without a cardiopulmonary bypass. Distal anastomoses were performed in the descending thoracic aorta with a partial occluding clamp. A composite woven...Continue Reading

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