Background and aim of the study: The study aim was to assess the surgical options and advantages of beating-heart aortic valve replacement (AVR) in patients with patent coronary artery bypasses.
Methods: In this prospective study, conducted between January and August 2006, four consecutive patients (mean age 77.5 +/- 6.6 years) each with patent coronary artery bypasses, underwent beating-heart AVR using two specific methods of myocardial perfusion based on the origin and status of the grafts, as assessed by preoperative angiography. Pre-operatively, all patients were in NYHA functional class III, and each received an aortic valve bioprosthesis.
Results: There were no hospital deaths. The mean duration of ICU stay was 3.2 +/- 1.3 days. One patient presented with transitory atrial fibrillation. At discharge, echocardiography confirmed normally functioning bioprostheses, with no significant transprosthetic gradient.
Conclusion: Beating-heart AVR with patent coronary artery bypasses using continuous myocardial perfusion is a reliable, simple and effective technique to reduce the risks of graft and myocardial injuries, and to achieve optimal preservation of the hypertrophic myocardium with coronary artery disease.