case_images: PMC11715061_01
case_images: Preoperative echocardiography findings: (a) parasternal long-axis view showing reduced aortic valve leaflets motion, (b) parasternal short-axis view showing significant calcification of aortic valve leaflets, (c) peak aortic jet velocity measured by CW doppler.
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case_images: Transthoracic echocardiography (TTE) showed significant AV calcification and reduced mobility of all three leaflets (mean gradient 57 mmHg, AV area (AVA) 0.49 cm2, AVA index 0.27 cm2) with less than moderate aortic regurgitation (Figure 1).
case_images: Invasive coronary angiography: right coronary artery ostium stenosis.
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case_images: Invasive angiography revealed localised proximal 90% right coronary artery (RCA) stenosis (Figure 2) and 75% left main coronary artery (LMCA) ostial stenosis (Figure 3).
case_images: Invasive coronary angiography: left coronary artery ostium stenosis.
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case_images: Invasive angiography revealed localised proximal 90% right coronary artery (RCA) stenosis (Figure 2) and 75% left main coronary artery (LMCA) ostial stenosis (Figure 3).
case_images: Left main coronary artery and proximal segment of right coronary artery surgical angioplasty using autopericardium patch; aortic valve replacement using tissue valve.
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case_images: Proximal RCA angioplasty was performed starting with direct incision into the proximal RCA and fresh autopericardium material (3 cm long and 3 mm wide) was also used for reconstruction (Figure 4).