Simultaneous percutaneous transcatheter aortic valve replacement and endovascular abdominal aortic aneurysm repair in a high risk patient with hostile aortic neck, a case report

Journal of Cardiothoracic Surgery

Richard G. Curl¹  Vijay Iyer²  Dimitrios Koudoumas¹ 

[1] SUNY at Buffalo, Department of Vascular Surgery, Buffalo General Medical Center, Gates Vascular Institute, 100 High Street, B-7, Buffalo 14203, NY, USA;SUNY at Buffalo, Department of Interventional Cardiology, Buffalo General Medical Center, Gates Vascular Institute, Buffalo, NY, USA

关键词: EVAR;    Abdominal aortic aneurysm;    TAVR;    Aortic stenosis;   

Others  :  1235241
DOI  :  10.1186/s13019-015-0392-9

 received in 2015-09-10, accepted in 2015-12-08,  发布年份 2015

【 摘 要 】

Background

Abdominal aortic aneurysm (AAA) can be a potential life threatening condition if left untreated. Total endovascular techniques to approach aortic aneurysms have extended management options and enabled patients who are unfit for open surgery to undergo repair. Transcatheter aortic valve replacement is increasingly used to treat patients with severe symptomatic aortic stenosis, who once were considered high risk for traditional open aortic valve replacement.

Results

Herein we report the complete simultaneous treatment of an infrarenal AAA with hostile neck and severe aortic stenosis in a patient deemed high risk for surgical repair.

Conclusion

Advances in catheter based endovascular technology have enabled physicians to approach patients with AAA and valvular pathology even with multiple comorbidities that otherwise would be poor surgical candidates, even in the presence of challenging anatomic considerations and various comorbidities.

【 授权许可】

   
2015 Koudoumas et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Kordowicz A, Ghosh J, Baguneid M. A single centre experience of simultaneous open abdominal aortic aneurysm and cardiac surgery. Interact Cardiovasc Thorac Surg. 2010; 10(1):63-6.
• [2]Lim S, Halandras PM, Park T, Lee Y, Crisostomo P, Hershberger R et al.. Outcomes of endovascular abdominal aortic aneurysm repair in high-risk patients. J Vasc Surg. 2015; 61(4):862-8.
• [3]Klokocovnik T, Span M, Gregoric ID. Minimally invasive sternotomy for aortic valve replacement followed by a minilaparotomy for abdominal aneurysm repair. Heart Surg Forum. 2008; 11(3):E181-3.
• [4]Thompson RW, Parks WC. Role of matrix metalloproteinases in abdominal aortic aneurysms. Ann N Y Acad Sci. 1996; 800:157-74.
• [5]Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014; 63(22):e57-185.
• [6]Walker TG, Kalva SP, Yeddula K, Wicky S, Kundu S, Drescher P et al.. Clinical practice guidelines for endovascular abdominal aortic aneurysm repair: written by the Standards of Practice Committee for the Society of Interventional Radiology and endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association. J Vasc Interv Radiol. 2010; 21(11):1632-55.
• [7]Regeer MV, Versteegh MI, Klautz RJ, Stijnen T, Schalij MJ, Bax JJ et al.. Aortic valve repair versus replacement for aortic regurgitation: effects on left ventricular remodeling. J Card Surg. 2015; 30(1):13-9.
• [8]Iezzi R, Cotroneo AR. Endovascular repair of abdominal aortic aneurysms: CTA evaluation of contraindications. Abdom Imaging. 2006; 31(6):722-31.
• [9]Turnbull IC, Criado FJ, Sanchez L, Sadek M, Malik R, Ellozy SH et al.. Five-year results for the Talent enhanced Low Profile System abdominal stent graft pivotal trial including early and long-term safety and efficacy. J Vasc Surg. 2010; 51(3):537-44.
• [10]Mehta M, Henretta J, Glickman M, Deaton D, Naslund TC, Gray B et al.. Outcome of the pivotal study of the Aptus endovascular abdominal aortic aneurysms repair system. J Vasc Surg. 2014; 60(2):275-85.
• [11]Aluko Y, Diehl L, Jacoby R, Chan B, Andrews S, McMillan E, et al. Simultaneous transcatheter aortic valve replacement and endovascular repair for critical aortic stenosis and large abdominal aortic aneurysm. Cardiovasc Revasc Med. 2015;16(4):254–8. doi: 10.1016/j.carrev.2014.12.001. Epub 2014 Dec 16.
• [12]Drury-Smith M, Garnham A, Khogali S. Critical aortic stenosis in a patient with a large saccular abdominal aortic aneurysm: simultaneous transcatheter aortic valve implantation and drive-by endovascular aortic aneurysm repair. Catheter Cardiovasc Interv. 2012; 80(6):1014-8.
• [13]Drury-Smith M, Garnham A, Khogali S. Sequential trans-catheter aortic valve implantation and abdominal aortic aneurysm repair. Catheter Cardiovasc Interv. 2012; 79(5):784-8.
• [14]Blochle R, Lall P, Cherr GS, Harris LM, Dryjski ML, Hsu HK et al.. Management of patients with concomitant lung cancer and abdominal aortic aneurysm. Am J Surg. 2008; 196(5):697-702.
• [15]Lauro S, Lanzetta G, Bria E, Trasatti L, Gelibter A, Vecchione A. Antiblastic chemotherapy in the presence of abdominal aorta aneurysm (AAA): guidelines. Anticancer Res. 1999; 19(2B):1439-44.