What Should Be the Systolic Cardiac Output in Aorta?

Abstract

Congratulations to the authors for this valuable study [1Brown J.W. Boyd J.H. Patel P.M. et al.Transcatheter aortic valve replacement versus aortic valve bypass: a comparison of outcomes and economics.Ann Thorac Surg. 2016; 101 (discussion 54–5): 49-54Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar]. They have put tremendous effort into the aortic valve bypass (AVB) technique. We have some concerns about this technique used in surgical treatment of severe aortic stenosis. Obviously, the duration of diastole is almost twofold that of systole. Bypassing the ascending aorta, aortic arch, and initial segment of the descending aorta with the AVB technique may have adverse results in terms of hypoperfusion. Are the authors eager to plan a simulation [2Kestelli M. Yilik L. Ozsöyler I. et al.Experimental study of a multiplaned mechanical aortic valve using bovine aorta.Int Heart J. 2005; 46: 133-138Crossref PubMed Scopus (5) Google Scholar] in which the systolic cardiac output was three times (i.e., 3 × 5 L) of the usual cardiac output? Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass: A Comparison of Outcomes and EconomicsThe Annals of Thoracic SurgeryVol. 101Issue 1PreviewTranscatheter aortic valve replacement (TAVR) is currently offered to patients who are high-risk candidates for conventional surgical aortic valve replacement. For the past 37 years, off-pump aortic valve bypass (AVB) has been used in elderly patients at our center for this similarly high-risk group. Although TAVR and AVB were offered to similar patients at our center, comparisons of clinical outcomes and hospital economics for each strategy were not reported. Full-Text PDF