A Previously Unreported Complication of Apicoaortic Conduit for Severe Aortic Stenosis

• Published in: The Annals of thoracic surgery Vol. 87; no. 3; pp. 927 - 928
• Main Authors: Parsa, Cyrus J., MD, Milano, Carmelo A., MD, Proia, Alan D., MD, PhD, Mackensen, G. Burkhard, MD, PhD, Hughes, G. Chad, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2009; Elsevier
• Subjects: Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aorta - surgery; Aortic Diseases - etiology; Aortic Valve Stenosis - surgery; Biological and medical sciences; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Cardiology. Vascular system; Cardiothoracic Surgery; Endocardial and cardiac valvular diseases; Fatal Outcome; Heart; Humans; Male; Medical sciences; Myocardial Infarction - etiology; Pneumology; Severity of Illness Index; Surgery; Thrombosis - etiology; 35; 18; Aortic stenosis; Cardiac valvular disease; Cardiovascular disease; Anesthesia; Complication; Circulatory system; Cardiology; Severe
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2008.07.061

Given the aging population, use of an apicoaortic conduit serves as an alternative method to treat severe aortic stenosis, especially in patients with a heavily calcified ascending aorta or prior cardiac surgery. Although an apicoaortic conduit fractionates systemic blood flow, it does so without significant deleterious effects. However, we report a novel complication with thrombosis of the aortic root and subsequent coronary insufficiency that likely resulted from a preponderance of cardiac output though the apicoaortic conduit with stagnation of native antegrade blood flow. Given increasing use of the apicoaortic conduit procedure, surgeons considering this approach should be familiar with this potential complication.