title: Implantation of transcatheter aortic valve prosthesis through the ascending aorta concomitant with coronary artery bypass grafting without cardiopulmonary bypass.
abstract: BACKGROUND
  The transcatheter aortic valve implantation in the treatment of high-risk symptomatic aortic stenosis has increased the number of implants every year. The learning curve for transcatheter aortic valve implantation has improved since the last 12 years, allowing access alternatives.
  
  
  OBJECTIVE
  The aim of this study is to approach the implantation of transcatheter aortic valve through transaortic via associated with off-pump cardiopulmonary bypass surgery in a 67-year-old man, with chronic obstructive pulmonary disease, arterial hypertension and kidney transplant.
  
  
  METHODS
  Off-pump coronary artery bypass surgery was performed and the valve in the aortic position was released successfully.
  
  
  RESULTS
  There were no complications in the intraoperative and postoperative period. Gradient reduction, effective orifice increasing of the prosthesis and absence of valvular regurgitation after implantation were observed by transesophageal echocardiography.
  
  
  CONCLUSIONS
  Procedural success demonstrates that implantation of transcatheter aortic valve through the ascending aorta associated with coronary artery bypass surgery without CPB is a new option for these patients.
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: João Carlos Ferreira
authors.initials: JC
authors.lastname: Leal
authors.affiliation: Associação de Medicina Intensiva Brasileira, São Paulo, SP, Brazil.
authors.forename: Luis Ernesto
authors.initials: LE
authors.lastname: Avanci
authors.affiliation: Hospital Beneficência Portuguesa de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Achilles
authors.initials: A
authors.lastname: Abelaira Filho
authors.affiliation: Hospital Beneficência Portuguesa de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Thiago Faria
authors.initials: TF
authors.lastname: Almeida
authors.affiliation: Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Domingo Marcolino
authors.initials: DM
authors.lastname: Braile
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome