Novosti
Khirurgii

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Year 2021 Vol. 29 No 4

CASE REPORTS

G.I. YEMETS, O.V. TELEHUZOVA, YE.A. CHERNETSKYI, G.B. MANKOVSKYI, YE.YU. MARUSHKO

MINI-INVASIVE AORTIC VALVE REPLACEMENT IN 97-YEAR PATIENT

Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev,
Ukraine

This review focuses on the choice of treatment strategy in elderly patients with severe aortic stenosis. The variability of surgical approaches and options, often limited due to excessive caution associated with the age-relative peculiarities of such patients has been shown in this study. The effectiveness of a multidisciplinary and integrated approach has been demonstrated, the result of which is measured by improving the quality and duration of the patient’s life. A case of mini-invasive aortic valve replacement in a 97-year-old patient is unique for the world literature. The key indicators that undoubtedly influence the choice of treatment tactics for an elderly patient are: the patient’s general condition, comorbidity and the ability of quick postoperative rehabilitation. Thus, minimally invasive surgery and transcatheter aortic valve implantation (TAVI) are considered to be the methods of choice for these patients. TAVI as an option is not always available, particular in countries with unstable economic conditions. In the given case, a multi-stage preoperative preparation of patient was performed to stabilize the general condition and to compensate the comorbidity. Thus, the preoperative period optimization for high-risk patients facilitated the rapid rehabilitation and adaptation after the operation. Any surgical procedure has risks associated with it, so the hybrid approach, widely used in a current clinical cardiac surgery, is especially valuable in the context of treating elderly patients, since it minimizes these risks.

Keywords: minimally invasive surgery, clinical observation, aortic valve stenosis, the elderly patients, cardiac surgery
p. 510-517 of the original issue
References
  1. Kwiecień A, Hrapkowicz T, Filipiak K, Przybylski R, Kaczmarczyk M, Kowalczuk A, Zembala M. Surgical treatment of elderly patients with severe aortic stenosis in the modern era – review. Kardiochir Torakochirurgia Pol. 2018 Sep;15(3):188-95. doi: 10.5114/kitp.2018.78445
  2. Osnabrugge RL, Mylotte D, Head SJ, Van Mieghem NM, Nkomo VT, LeReun CM, Bogers AJ, Piazza N, Kappetein AP. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013 Sep 10;62(11):1002-12. doi: 10.1016/j.jacc.2013.05.015
  3. Pellikka PA, Sarano ME, Nishimura RA, Malouf JF, Bailey KR, Scott CG, Barnes ME, Tajik AJ. Outcome of 622 adults with asymptomatic, hemodynamically significant aortic stenosis during prolonged follow-up. Circulation. 2005 Jun 21;111(24):3290-95. doi: 10.1161/CIRCULATIONAHA.104.495903
  4. Chizner MA, Pearle DL, deLeon AC Jr. The natural history of aortic stenosis in adults. Am Heart J. 1980 Apr;99(4):419-24. doi: 10.1016/0002-8703(80)90375-0
  5. Winkley Shroyer AL, Bakaeen F, Shahian DM, Carr BM, Prager RL, Jacobs JP, Ferraris V, Edwards F, Grover FL. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: The Driving Force for Improvement in Cardiac Surgery. Semin Thorac Cardiovasc Surg. 2015 Summer;27(2):144-51. doi: 10.1053/j.semtcvs.2015.07.007
  6. Rao PN, Kumar AS. Aortic valve replacement through right thoracotomy. Tex Heart Inst J. 1993;20(4):307-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC325118/
  7. Phan K, Xie A, Di Eusanio M, Yan TD. A meta-analysis of minimally invasive versus conventional sternotomy for aortic valve replacement. Ann Thorac Surg. 2014 Oct;98(4):1499-511. doi: 10.1016/j.athoracsur.2014.05.060
  8. Bloomfield P. Choice of heart valve prosthesis. Heart. 2002 Jun;87(6):583-89. doi: 10.1136/heart.87.6.583
  9. ElBardissi AW, Shekar P, Couper GS, Cohn LH. Minimally invasive aortic valve replacement in octogenarian, high-risk, transcatheter aortic valve implantation candidates. J Thorac Cardiovasc Surg. 2011 Feb;141(2):328-35. doi: 10.1016/j.jtcvs.2010.08.056
Address for correspondence:
04050 Ukraine, Kiev,
Ilyenko Str., Ukrainian Children’s Cardiac
Center of the Ministry of Health of Ukraine,
tel. +3 80687044822,
e-mail: teleguzova5@gmail.com,
Telehuzova Alexandra V.
Information about the authors:
Yemets Gleb I., Cardiovascular Surgeon, the Department of Congenital and Acquired Heart Defects in Adults and Adolescents, Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
https://orcid.org/0000-0002-6139-6235
Telehuzova Alexandra V., Cardiologist, the Department of Congenital and Acquired Heart Defects in Adults and Adolescents, Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
https://orcid.org/0000-0003-4801-093X
Chernetskiy Yevheniy A., Cardiologist, the Department of Congenital and Acquired Heart Defects in Adults and Adolescents, Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
https://orcid.org/0000-0002-4487-6819
Mankovsky Georgiy B., PhD, Interventional Cardiologist, the Department of Emergency X-Ray Diagnostics, Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
https://orcid.org/0000-0003-4980-4571
Marushko Yevheniy Yu., PhD, Interventional Cardiologist, the Department of Emergency X-Ray Diagnostics, Ukrainian Children’s Cardiac Center of the Ministry of Health of Ukraine, Kiev, Ukraine.
https://orcid.org/0000-0002-0696-9926
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