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  • Title: Combined transapical aortic valve replacement and minimally invasive direct coronary bypass grafting--a new concept for selected high-risk patients.
    Author: Mellert F, Breuer J, Probst C, Welz A, Schiller W.
    Journal: Heart Surg Forum; 2011 Feb; 14(1):E61-3. PubMed ID: 21345778.
    Abstract:
    BACKGROUND: Transcatheter aortic valve implantation and minimally invasive direct coronary artery bypass (MIDCAB) procedures are both off-pump treatment options for a subset of higher-risk patients. We present a new, minimally invasive surgical concept involving combining the procedures and performing them through the same thoracic access in a patient with a vascular disorder. CASE REPORT: We report on a 78-year-old patient with symptomatic calcified aortic stenosis and a critical lesion of the left anterior descending coronary artery. In addition, Rendu-Osler-Weber disease was diagnosed. He was successfully treated with combined off-pump transapical, transcatheter aortic valve implantation and MIDCAB grafting. The initial postoperative recovery was good; however, the patient died 3 months postoperatively from septic complications. CONCLUSION: This combined procedure performed through the same anterolateral incision was technically feasible and may be a promising, minimally invasive approach for selected patients.
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