Back to Journals » Therapeutics and Clinical Risk Management » Volume 8

Interdisciplinary three-step strategy to treat aortic stenosis and coronary artery disease in a patient with end-stage chronic obstructive pulmonary disease

Authors Michel S, Bigdeli, Beiras-Fernandez A, Schmitz, Wolf, Sodian, Kaczmarek

Received 20 December 2011

Accepted for publication 28 January 2012

Published 11 April 2012 Volume 2012:8 Pages 181—183

DOI https://doi.org/10.2147/TCRM.S29343

Review by Single anonymous peer review

Peer reviewer comments 4



Sebastian Michel1, Amir K Bigdeli1, Andres Beiras-Fernandez2, Christoph Schmitz1, Manuel Wolf1, Ralf Sodian1, Ingo Kaczmarek1
1Department of Cardiac Surgery, Ludwig Maximilians University of Munich, Munich, Germany; 2Department of Thoracic and Cardiovascular Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany

Background: Valvular aortic stenosis is a common disease in the elderly, often in multimorbid patients. It is often associated with coronary artery disease and peripheral artery disease. In this situation, the risk of conventional open-heart surgery is too high, and other treatment strategies have to be evaluated.
Case report: A 79-year-old female patient with severe aortic stenosis, coronary artery disease and end-stage chronic obstructive pulmonary disease suffering from dyspnea at rest and permanently dependent on oxygen was treated in three steps. Firstly, her pulmonary infection was treated with antibiotics for 7 days. Then, the left anterior descending artery was stented (bare-metal stent). In the same session, valvuloplasty of the aortic valve was performed. She was sent to rehabilitation to improve her pulmonary condition and took clopidogrel for 4 weeks. Finally, she underwent transapical aortic valve replacement. She was released to rehabilitation on postoperative day 12.
Conclusion: A combination of modern interventional and minimally invasive surgical techniques to treat aortic stenosis and coronary heart disease can be a viable option for multimorbid patients with extremely high risk in conventional open-heart surgery.

Keywords: aortic stenosis, transapical aortic valve replacement, minimally invasive cardiac surgery

Creative Commons License © 2012 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.