A Unique Hybrid Approach to Complex Re-Do Aortic Root Surgery

Heart Lung Circ. 2017 Nov;26(11):e68-e70. doi: 10.1016/j.hlc.2017.05.126. Epub 2017 Jun 1.

Abstract

Background: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) and mitral valve (MV) repair remotely, followed by two further operations for endocarditis and aortic root abscess.

Methods: The risk associated with the redo surgery required detailed planning and innovative techniques to allow it to be performed safely. These included femoral cannulation for cardiopulmonary bypass, venting the left ventricular apex via a small left anterior thoracotomy, use of a CODA® (COOK Medical, Bloomington USA) balloon to occlude the distal ascending aorta (placed via left brachial artery) and finally, the use of a PROPLEGE® (Edwards Lifesciences, Irvine, USA) retrograde cardioplegia cannula (placed via right internal jugular vein).

Keywords: Endo-aortic balloon; Percutaneous retrograde cardioplegia; Re-do cardiac surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, False / etiology
  • Aneurysm, False / pathology
  • Aneurysm, False / surgery*
  • Aortic Aneurysm / etiology
  • Aortic Aneurysm / pathology
  • Aortic Aneurysm / surgery*
  • Endocarditis / pathology
  • Endocarditis / surgery
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Male
  • Mitral Valve / surgery
  • Surgical Wound Dehiscence / pathology
  • Surgical Wound Dehiscence / surgery*