|
1
|
Koutsias S, Karaolanis GI, Papafaklis MI, Peroulis M, Tzimas P, Lakkas L, Mitsis M, Naka KK, Michalis LK. Simultaneous Transcatheter Aortic Valve Implantation and Infrarenal Aortic Aneurysm Repair for Severe Aortic Stenosis and Abdominal Aortic Aneurysm: Report of 2 Cases and Literature Review. Vasc Endovascular Surg 2020; 54:544-548. [PMID: 32458751 DOI: 10.1177/1538574420927864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The prevalence of concomitant abdominal aortic aneurysm (AAA) and severe aortic stenosis (AS) has been increasing in the elderly population. Both conditions have adverse outcomes, if not adequately managed. No clear recommendations are available in the literature until today, in regards of the management sequence making thus the decision-making challenging. We report 2 cases of AAA and significant AS treated with endovascular aortic repair (EVAR) and transcatheter aortic valve implantation (TAVI) during the same procedure and a review of the literature on this topic. Based on our experience, the combined procedure with TAVI followed by EVAR seems to be feasible, safe, and effective while detailed preoperative planning and a carefully tailored management strategy by a multidisciplinary team are essential.
Collapse
Affiliation(s)
- Stylianos Koutsias
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Georgios I Karaolanis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail I Papafaklis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail Peroulis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Petros Tzimas
- Department of Anesthesiology, University Hospital of Ioannina, Ioannina, Greece
| | - Lampros Lakkas
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Michail Mitsis
- Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Lampros K Michalis
- Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
| |
Collapse
|
|
2
|
Weber C, Deppe AC, Eghbalzadeh K, Scherner M, Gray D, Majd P, Gawenda M, Rosenkranz S, Rudolph T, Madershahian N, Wahlers T. Transfemoral transcatheter aortic valve implantation in a patient with multiple endovascular aortic stents--a case report. J Cardiothorac Surg 2016; 11:24. [PMID: 26832960 PMCID: PMC4736172 DOI: 10.1186/s13019-016-0421-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/26/2016] [Indexed: 11/10/2022] Open
Abstract
Background In patients undergoing transfemoral transcatheter aortic valve implantation, previous endovascular interventions bear a risk for the valve frame to get stucked to the aortic stents. Case Presentation We report on a 75-year-old frail patient with severe aortic stenosis and a rapid increase of an infra-renal aneurysm. He had a history of multiple endovascular interventions on the aorta. Due to his frail preoperative status we decided to perform a transfemoral transcatheter aortic valve implantation in combination with a simultaneous surgical abdominal aneurysm repair. To allow an atraumatic passage of the Edwards SAPIEN 3 valve across the endovascular stents we used a special technique. Conclusions The transfemoral approach in patients with previous endovascular stenting can be performed successfully by a partial inflation of the distal balloon.
Collapse
Affiliation(s)
- Carolyn Weber
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Antje-Christin Deppe
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Kaveh Eghbalzadeh
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Maximilian Scherner
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Daphne Gray
- Department of Vascular Surgery, University of Cologne, Cologne, Germany
| | - Payman Majd
- Department of Vascular Surgery, University of Cologne, Cologne, Germany
| | - Michael Gawenda
- Department of Vascular Surgery, University of Cologne, Cologne, Germany
| | | | - Tanja Rudolph
- Department of Cardiology, University of Cologne, Cologne, Germany
| | - Navid Madershahian
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| |
Collapse
|