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J Thorac Cardiovasc Surg 2009;138:1016-1017
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

First successful transapical aortic valve implantation after aortic allograft replacement

^a Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany
^b Department of Internal Medicine I, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany
^c Department of Radiology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany

Received for publication May 4, 2009; accepted for publication May 17, 2009.

^_* Address for reprints: Michael Schmoeckel, MD, Department of Cardiac Surgery, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, D-81377 Munich, Germany. (Email: michael.schmoeckel@med.uni-muenchen.de).

The first 20% of the full text of this article appears below.

	Introduction

 
Aortic allograft reoperation may be difficult, especially when the first procedure was done by miniroot replacement.¹ We report the case of a 72-year-old patient with increasing dyspnea from severe valvular regurgitation 13 years after aortic allograft replacement and simultaneous coronary artery bypass grafting. A patent left internal thoracic artery to the left anterior descending coronary artery and a venous graft to a diagonal branch were seen on computed tomography and angiography.

Because we had performed 33 transapical valve implantations (Edwards SAPIEN; Edwards Inc, Unterschleissheim, Germany) with a 30 day mortality of 3%, we were confident in the catheter-based implantation of a pericardial valve into this calcified aortic allograft wall.

	Clinical Summary

 
In 1996, the 59-year-old male patient had undergone surgery for aortic stenosis and coronary artery disease. At that time, a 24-mm aortic allograft was implanted as a miniroot, the left internal thoracic artery was anastomosed to the left anterior descending coronary artery, and a saphenous vein graft was connected to the second diagonal . . . [Full Text of this Article]

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