Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Language Japanese
Title Simultaneous Transcatheter Aortic Valve Implantation and Off-Pump Coronary Artery Revascularization in High-Risk Patients
Conference The 24th Annual Meeting of the Japanese Association for Coronary Artery Surgery
Promoters Japanese Association for Coronary Artery Surgery
Conference Type Nationwide Conferences
Presentation Type Speech
Date 2019/07/11
Summary As the indication of Transcatheter Aortic Valve Implantation (TAVI) is expanded,the number of patients of aortic stenosis (AS) with coronary artery disease(CAD) is expected to increase but the appropriate choice of treatment for these patients is still unknown. We report two cases of Simultaneous Off-Pump Coronary Artery grafting (OPCAB) and TAVI in high-risk patients. Case1:80-yearold female who presented with chronic heart failure due to AS and CAD. She also had liver cirrhosis, chronic kidney disease and peripheral artery disease. Her STS risk score and SYNTAX Score were calculated as 31.3% and 39 respectively. Case2: 86-year-old female who was referred to us for treatment of unstable angina. Echocardiography revealed the presence of severe AS. Her STS risk score and SYNTAX Score were calculated as 8.4% and 19 respectively. In both patients, a full sternotomy allowed off- pump arterial and vein graft anastomosis and them, transaortic TAVI was performed. There was no conversion to on-pump procedure and no hospital deaths. Hybrid OPCAB and TAVI is a feasible option for high-risk patients with aortic stenosis and coronary artery disease.