Postperfusion coronary ostial stenosis

Midell, Allen I.; DeBoer, Arthur; Bermudez, Gustave

doi:10.1016/s0022-5223(19)40095-0

Cited by 43 publications

(7 citation statements)

References 16 publications

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“…The incidence of coronary artery stenosis following AVR is well reported. [9][10][11][12][13] The incidence of stenosis of the coronary ostium is believed to be less than 1%-5% of all AVR operations and can be attributed to various causes such as direct ostial administration of cardioplegic solution causing local hyperplasia and ostial trauma due to over dilatation by the tip of the cardioplegic cannula. 14 The technique of cardioplegia evolved in our institute over the 15 years of the study period.…”

Section: Discussionmentioning

confidence: 99%

Coronary ostial compromise in aortic valve replacement: An avoidable complication

Farid

Page

Howell

et al. 2015

Asian Cardiovasc Thorac Ann

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Section: Discussionmentioning

confidence: 99%

Coronary ostial compromise in aortic valve replacement: An avoidable complication

Farid

Page

Howell

et al. 2015

Asian Cardiovasc Thorac Ann

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“…post infarct VSDs), 23 –29 the use of continuous perfusion to perform valve surgery after previous surgery especially in the presence of patent grafts, which decreases the risk of dissecting and injuring them, 30 –39 and finally the reports by Dr Salerno and his colleagues from Miami introducing the principles of simultaneous antegrade/retrograde warm blood perfusion. 40 –47 All reported satisfactory outcomes.…”

Section: Methodsmentioning

confidence: 95%

“…This was associated with complications, such as coronary ostial stenosis, catheter dislodgment, and the risk of inadequate myocardial protection. [45][46][47] This practice almost disappeared after the introduction of cardioplegia which provided an easier and safer way to operate on a still heart. It enabled the performance of a broader range of cardiac procedures, and avoided the potential difficulties of continuous perfusion on a beating heart.…”

Section: Discussionmentioning

confidence: 99%

Beating-Heart Valve Surgery: A Systematic Review

Salhiyyah

Taggart

2009

Asian Cardiovasc Thorac Ann

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Beating-heart continuous coronary perfusion (BHCCP) has been promoted as an alternative to the technique of cardioplegic arrest in valve surgery. Its potential advantage is the elimination of cardioplegia and the corollary risk of ischemic reperfusion injury. The use of CCP has been recommended especially when performing more complex operations, such as mitral valve repair, and particularly as surgeons become more familiar with beating-heart coronary surgery. We conducted a systematic review to assess the strength of the evidence supporting the efficacy of BHCCP compared to cardioplegia in valve surgery. Thirty nine reports were identified. Of these, only two were randomized control trials. Overall the studies were generally of poor quality and had a low evidence level. In those studies, mortality and major morbidity from BHCCP were within acceptable levels, nevertheless, there was no advantage over cardioplegic arrest. On the other hand there is weak evidence that it may reduce functional and biochemical markers of myocardial injury. In conclusion, BHCCP is an operative strategy in valve surgery with some potential benefits. There is, however a need for a high quality, prospective, randomized control trial to establish the exact role for BHCCP in complex valve surgery.

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“…[7][8][9][10] Ostial stenosis from injury after coronary intervention or cardiac surgery is a possible etiology and should be suspected in the appropriate context. 11,12 Ostial injury is related to cannulation of the LMCA either during percutaneous intervention or bypass surgery. LMCA dissection or thrombosis may occur during angiography or intervention but it is infrequent.…”

Section: Etiologymentioning

confidence: 99%

“…Another possible etiology is radiation aortitis, which usually involves the ostium of LMCA, and may occur 5–16 years after radiation therapy 7–10 . Ostial stenosis from injury after coronary intervention or cardiac surgery is a possible etiology and should be suspected in the appropriate context 11,12 . Ostial injury is related to cannulation of the LMCA either during percutaneous intervention or bypass surgery.…”

Section: Etiologymentioning

confidence: 99%

Percutaneous Intervention of Unprotected Left Main Coronary Artery

Sadeghi

O’Neill

Grines

2003

J Interven Cardiology

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Successful percutaneous intervention of unprotected left main coronary artery (LMCA) in lieu of surgical revascularization represents the next wave of challenges that the field of interventional cardiology will try to overcome. Significant LMCA stenosis, commonly secondary to atherosclerosis, is seen in about 4-10% of cases presenting to the cardiac catheterization laboratory. Currently, the vast majority of these patients undergo surgical revascularization unless there are prohibitive reasons for surgical revascularization. Several challenges of percutaneous revascularization have been overcome with stents, intravascular brachytherapy, and other technical improvements. Yet, several remaining limitations of percutaneous intervention, such as in-stent restenosis, have to be improved further before randomized clinical trials of surgical and percutaneous revascularization of unprotected LMCA disease can be contemplated to establish a new standard of care.

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Postperfusion coronary ostial stenosis

Cited by 43 publications

References 16 publications

Coronary ostial compromise in aortic valve replacement: An avoidable complication

Coronary ostial compromise in aortic valve replacement: An avoidable complication

Beating-Heart Valve Surgery: A Systematic Review

Percutaneous Intervention of Unprotected Left Main Coronary Artery

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