The transventricular-transseptal access to the aortic root: a new route for extrapleural trans-catheter aortic stent-valve implantation

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Ligang LiuLudwig K von Segesser

Abstract

The aim of this study was to investigate the feasibility of transventricular-transseptal approach (TVSA) for extrapleural trans-catheter aortic valved stent implantation via a subxyphoidian access. In five porcine experiments (52.3 ± 10.9 kg) the right ventricle was exposed via subxyphoidian access. Under the guidance of intracardiac echocardiography (ICE) and fluoroscopy, the transseptal access from right ventricle to left ventricle was created progressively by puncture and dilation with dilators (8F-26F). Valved stents built in-house from commercial tanned pericardium and self-expandable Nitinol stents were loaded into a cartridge. A delivery sheath was then introduced from the right ventricle into the left ventricle and then into the ascending aorta. The cartridge was connected and the valved stent was deployed in the aortic position. Then, the ventricular septal access was sealed with an Amplatzer septal occluder device and the right ventricular access was closed by tying prepared purse-string suture directly. Thirty minutes after the whole procedure, the animals were sacrificed for macroscopic evaluation of the position of valved stent and septal closure device. Procedural success of TVSA was 100% at the first attempt. Mea...Continue Reading

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Aug 5, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jun Qing ZhouLudwig K von Segesser
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Jun 16, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Enrico FerrariLudwig Karl von Segesser
Jul 31, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Martins KalejsLudwig Karl von Segesser
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Aug 25, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bettina Marty, Bernhard Egger

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Citations

Jul 30, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Volkmar Falk
Mar 20, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ludwig K von Segesser
May 7, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Marmar VaseghiKalyanam Shivkumar
Mar 18, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Chaowu YanShijie Hao
Jun 18, 2011·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Tilo Kölbel, Eike Sebastian Debus
Jan 22, 2013·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Majdi HalabiRobert J Lederman

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