Surgical options for beating-heart aortic valve replacement in patients with patent coronary artery bypass.
OBJECTIVE
The study aim was to assess the surgical options and advantages of beating-heart aortic valve replacement (AVR) in patients with patent coronary artery bypasses.


METHODS
In this prospective study, conducted between January and August 2006, four consecutive patients (mean age 77.5 +/- 6.6 years) each with patent coronary artery bypasses, underwent beating-heart AVR using two specific methods of myocardial perfusion based on the origin and status of the grafts, as assessed by preoperative angiography. Pre-operatively, all patients were in NYHA functional class III, and each received an aortic valve bioprosthesis.


RESULTS
There were no hospital deaths. The mean duration of ICU stay was 3.2 +/- 1.3 days. One patient presented with transitory atrial fibrillation. At discharge, echocardiography confirmed normally functioning bioprostheses, with no significant transprosthetic gradient.


CONCLUSIONS
Beating-heart AVR with patent coronary artery bypasses using continuous myocardial perfusion is a reliable, simple and effective technique to reduce the risks of graft and myocardial injuries, and to achieve optimal preservation of the hypertrophic myocardium with coronary artery disease.
Grandmougin
Daniel
D
Department of Cardiovascular Surgery, Hôpital Bon-Secours, Metz, France. d.grandmougin@tiscali.fr
Delolme
Maria-Christina
MC
Derouck
David
D
Yammine
Nabil
N
Minetti
Christophe
C
Rahmati
Mohamad
M
Suleiman
Daoud
D
Genco
Gaétan
G
Roux
Pierre-Michel
PM
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000637:transplantation*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D015425:Myocardial Reperfusion / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency