Concomitant bilateral lung volume reduction surgery and aortic valve replacement: Multidisciplinary strategies in achieving a successful outcome

Abstract

Significant cardiac comorbidity is generally considered a contraindication for lung volume reduction surgery (LVRS). We described a multidisciplinary approach that led to the successful management of a 53-year-old woman with severe aortic stenosis who had a forced expiratory volume in 1 second (FEV 1 ) of 20% predicted secondary to smoking-related end-stage emphysema. CLINICAL SUMMARYA 53-year-old woman was referred for aortic valve replacement (AVR). She had symptomatic (angina and dizzy spells) severe aortic stenosis (aortic valve area 0.8 cm 2 , echocardiographic peak gradient 93 mm Hg, mean gradient 62 mm Hg), moderate aortic regurgitation, left ventricular hypertrophy, and left ventricular dysfunction. She had

Successful combined bilateral lung volume reduction and coronary artery bypass grafting surgery: Implications and advantages

“…Untreated symptomatic severe aortic stenosis, however, is associated with a poor prognosis. 3 In contrast, patients who undergo successful AVR for symptomatic aortic stenosis experience a significant survival benefit. 3 Appropriate case selection allied with careful perioperative planning in this case resulted in QOL, functional, pulmonary, and prognostic benefits.…”

“…3 In contrast, patients who undergo successful AVR for symptomatic aortic stenosis experience a significant survival benefit. 3 Appropriate case selection allied with careful perioperative planning in this case resulted in QOL, functional, pulmonary, and prognostic benefits. A multidisciplinary approach was essential in providing an optimal outcome.…”

“…A multidisciplinary approach previously described was adopted. 3 A thoracic epidural catheter was placed 4 hours before the scheduled operation to minimize the risk of epidural hematoma related to the impending systemic anticoagulation required for cardiopulmonary bypass (CPB) for CABG. The operation was performed through a median sternotomy.…”