Quality of Life
In this high-risk elderly population it is paramount to carefully weigh
the cost and benefit of intervention. The goal of care is not only to
prolong survival, but to provide symptomatic relief allowing patients to
enjoy their life and minimize undue risks of adverse events which may
take away from it. Coronary revascularization and AVR both greatly
increase patient functional status and quality of life compared to
medical management[6,11]. TAVR and anaortic OPCAB
minimize operative trauma, thus decreasing length of ICU and hospital
stay, prolonged ventilation, and need for re-exploration due to
bleeding[25,26]. In line with this, all of our
patients enjoyed a short length of stay in the ICU as well as the
hospital with minimal morbidities associated with our operation. This
allowed them to return to their daily lives with improved symptoms,
which is the ultimate goal of surgical intervention. Without this
technique, many surgeons would deny these high risk, elderly patients an
operation as it would technically be contraindicated. We have shown that
with this novel technique, surgeons can safely provide these patients
with an option to solve both their coronary artery disease and aortic
stenosis and overall improve their quality of life. We do anticipate
that with our aging population and increased prevalence of
atherosclerotic disease, surgeons will be faced with patients like our
patients in this cohort more frequently in the coming years.