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Aortic sutureless bioprosthesis with concomitant Ferrazzi procedure, Coronary revascularization and Neo-fenestrated pericardial reconstruction: report of a case

  • Faizus Sazzad1,
  • Vidanaptthirana Chirantha Puwalani1,
  • Chang Guohao1,
  • Julian Tan2 and
  • Theodoros Kofidis1
Journal of Cardiothoracic Surgery201510(Suppl 1):A309

Published: 16 December 2015


Coronary RevascularizationAortic Valve StenosisConcomitant ProcedureApical AreaStoma Creation


The clinical outcome of sutureless aortic bioprosthesis in concomitant complex heart surgery is still unclear.


We assessed a patient with large left ventricular aneurysm underwent concomitant procedure.


We report a case of 66 years Malay gentleman, diagnosed as large LV aneurysm (7.8 × 4.9 × 8.0 cm) secondary to previous anterior MI, Moderate aortic valve stenosis, Triple vessel coronary disease; underwent LV aneurysmectomy (Ferrazzi procedure) removal of LV thrombus, Sutureless aortic valve replacement (Perceval S), Coronary revascularization and Neo-fenestrated pericardial reconstruction with intra-aortic balloon counter pulsation support. At operation the large LV aneurysm was found at anterior-inferior apical area and was self-limiting leaking at the apical area (Almost ruptured) and was in-folded and got adherent to RV wall. Cardio-pulmonary bypass time was 199 min, and Cross-clamp 146 min.


Post operatively patient underwent resternotomy for bleeding and chest wash out on post-op day 1.Complicated with Bowel perforation and needed emergency exploratory laparotomy, Descending colon resection, with double barrel stoma creation, subsequently recovered well. Post op TTE showed LVIDD came down to 50 mm (Preoperative 72) with improved ejection fraction and good functioning sutureless valve.


Duration of surgery in complex concomitant procedure is an influencing factor for successful outcome. Sutureless aortic bioprosthesis reduces the operative length hence its use should be prioritized in such cases.


Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Authors’ Affiliations

Department of Cardiac Thoracic and Vascular Surgery, National University Hospital, Singapore, Singapore
Tan Tock Seng Hospital, Singapore, Singapore


© Sazzad et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.