Background and aim of the study: The study aim was to assess the surgical options and advantages of beating-heart aortic valve replacement (AVR) in patients with patent coronary artery bypasses.
Methods: In this prospective study, conducted between January and August 2006, four consecutive patients (mean age 77.5 ± 6.6 years) each with patent coronary artery bypasses, underwent beating-heart AVR using two specific methods of myocardial perfusion based on the origin and status of the grafts, as assessed by preoperative angiography. Preoperatively, all patients were in NYHA functional class III, and each received an aortic valve bioprosthesis.

Results: There were no hospital deaths. The mean duration of ICU stay was 3.2 ± 1.3 days. One patient presented with transitory atrial fibrillation. At discharge, echocardiography confirmed normally functioning bioprostheses, with no significant transprosthetic gradient.
Conclusion: Beating-heart AVR with patent coronary artery bypasses using continuous myocardial perfusion is a reliable, simple and effective technique to reduce the risks of graft and myocardial injuries, and to achieve optimal preservation of the hypertrophic myocardium with coronary artery disease.

The Journal of Heart Valve Disease 2007;16:235-239