Results
The mean age at the time of surgery was 77 +/- 5.67 years old (Table 1). All patients presented with severe aortic stenosis by AHA criteria7. Mean aortic valve area was 0.78 ± 0.13 cm2 with a mean pressure gradient of 44 ± 12.7 mmHg. All patients presented with coronary artery disease requiring revascularization via CABG. 4 (50%) patients presented with 3 vessel disease, 2 (25%) with L MCA stenosis, and 3 (38%) with proximal LAD stenosis. All 8 (100%) patients presented with a porcelain aorta and multiple other comorbidities precluding safe use of cardiopulmonary bypass and aortic cross-clamping (Table 1). 1 (14%) patient had previous PCI with restenosis requiring repeat intervention.
All patients underwent TAVR without any findings of postoperative leak on TEE. An average of 2.25 ± 0.89 vessels were bypassed. Interventional details are listed in Table 2.
Device success was achieved in 100% of patients. In-hospital and 30-day mortality were 0%. Complications included heart block in 2 (25%) patients, atrial fibrillation in 3 (38%), and 1 (13%) patient requiring pacemaker implantation. Postoperative outcomes are presented in Table 3.