[HSF] Calcified aortic stenosis

[Salerno, Tomas]

I have done three of such patients with porcelain aortas in the last few yearas. In each case, I was able to find a place in the distal aorta to cannulate, and a soft spot where a cross-clamp could be applied after systemic flow was decreased.  None of the patients had neurological problems after surgery, although the operation was rather tedious.


Tomas

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of jbflegejr at aol.com
Sent: Sunday, July 01, 2007 9:33 AM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Calcified aortic stenosis

Apico-aortic conduit is one possibility. Another could be hypothermic 
circulatory arrest and replace the valve while arrested, or replace the 
ascending aorta, clamp the graft and resume circulation and then 
replace the valve. John Flege


-----Original Message-----
From: Mitch Lirtzman <drmitch at cox.net>
To: OpenHeart-L at hsforum.com
Sent: Sat, 30 Jun 2007 7:48 pm
Subject: [HSF] Calcified aortic stenosis






To the forum. I know we've covered this type of problem in previous
discussions, but... 
 

An old patient of mine, 62yo petite diabetic female, unrepentant smoker
2ppd x 50yrs, had successful CABx3 in 2001- LIMA/ 2 veins. She's been
complaining of increasing dyspnea for several months and referred her 
back
to her cardiologist to investigate. The bottom line is she has critcal 
AS
with AVA 0.3cms, normal EF, normal chambers, and all grafts are patent. 
She
just had her left subclavian stent redone to improve LIMA flow. The 
problem
is she is now totally calcified from valve through arch and LCCA is
occluded just after the origin. Additionally, she now has a 1.5cm LUL
nodule which lights up on PET. Surprisingly, her PFT is remarkably good 
but
she always reminds me that she had a difficult post op course from a
pulmonary standpoint. 

Any thoughts besides the word NO? 

Thanks ahead of time. 

Mitch Lirtzman 
 


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