Simultaneous hybrid off-pump coronary artery bypass grafting and transcatheter aortic valve implantation in elderly patients.

Content Provider	Europe PMC
Author	Honda, Kentaro Wada, Teruaki Kunimoto, Hideki Fujimoto, Takahiro Matsuda, Maiko Ikuchi, Mizuho Furuta, Yoshiki Agematsu, Kota Shiono, Yasutsugu Kitabata, Hironori Tanaka, Atsushi Nishimura, Yoshiharu
Abstract	Purpose Optimal strategy for transcatheter aortic valve implantation (TAVI) in patients with coronary artery disease (CAD) is unresolved. We evaluated the surgical outcomes of hybrid coronary artery bypass grafting (CABG) and TAVI in elderly patients. Methods We retrospectively evaluated patients who underwent simultaneous TAVI and CABG at Wakayama Medical University, Japan. All patients underwent off-pump CABG (OPCAB) including minimally invasive cardiac surgery (MICS-CABG). In an earlier period, OPCAB + transfemoral TAVI (TF-TAVI) was the only method used, while in a later period, we introduced MICS-CABG and alternative approaches for TAVI. Results Twenty-seven patients were enrolled, the average age was 83.6 ± 5.1 years. In the MICS-CABG and TAVI group, average patient age was higher (87.0 ± 3.1 years) than in the earlier group. Thirty-day and in-hospital mortalities were zero. Incomplete revascularization rate was 33.3% and one patient required percutaneous coronary intervention after the operation. Graft patency rate was 100%. In MICS-CABG group, the number of distal anastomoses was smaller (1.29, range 1–2), but the number of days required to re-starting walking and postoperative hospital stay were shorter, and the rate of discharge to home was higher (100%) than in the other groups. Conclusions Although 33.3% of patients did not achieve complete revascularization, there was no 30-day or in-hospital mortality. TAVI and hybrid OPCAB, including MICS-CABG, were suggested to be feasible treatment in elderly patients.
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ISSN	09709134
Volume Number	39
DOI	10.1007/s12055-023-01577-6
PubMed Central reference number	PMC10597934
Issue Number	6
PubMed reference number	37885936
Journal	Indian Journal of Thoracic and Cardiovascular Surgery [Indian J Thorac Cardiovasc Surg]
e-ISSN	09737723
Language	English
Publisher	Springer Nature Singapore
Publisher Date	2023-08-29
Publisher Place	Singapore
Access Restriction	Open
Rights License	© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Subject Keyword	TAVI and hybrid OPCAB MICS-CABG TAVI and CAD
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine