DSS is a variable, unpredictable and progressive disease; recurrent obstruction may reappear despite the adequacy of surgical excision, and is not related to preoperative gradient. Mild AI remains substantially unchanged and AVR is indicated in severe AI.

INTRODUCTIONSurgical coronary revascularization is being performed with ever increasing frequency in patients at high surgical risk. Off-pump coronary artery bypass grafting (OPCABG) is particularly appealing in such subjects, but may limit the options for concomitant mechanical circulatory support.PRESENTATION OF CASEWe hereby report an original case of mechanical circulatory support with the Impella Recover LP 5.0 device during OPCABG in a 61-year-old gentleman with multiple comorbidities and severe left ventricular systolic dysfunction. Specifically, the soft tipped device did not impede surgical manipulation of the heart during the surgical procedure, providing uninterrupted circulatory support to the patient.DISCUSSIONThis clinical vignette supports the feasibility, safety and efficacy of the Impella Recover LP 5.0 device in patients undergoing OPCABG.CONCLUSIONPending further studies, use of the Impella Recover LP 5.0 device can be envisioned safely for OPCABG.

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Background/Introduction Patients undergoing coronary surgery are changed in the last years becoming a challenge for the cardiac surgeon not only for the quality of the coronary artery involved in the disease but also for the quality of patients. Low ejection fraction, elderly, COPD, kidney failure, Diabetes are often found in patients with coronary artery disease undergoing CABG.

Sixty percent of thoracic aortic aneurism involve the aortic root/or ascending aorta. The optimal timing of surgical repair remains uncertain despite most surgeons prefer to treat the aneurysm at a diameter of ≥5,5cm. This paper describes our off pump option for the treatment of isolated asending aorta aneurism with a diameter between 5,0 and 5,5 cm.