Transcatheter aortic valve implantation: the transaortic approach

Asian Cardiovascular & Thoracic Annals
Simon Cy ChowRandolph Hl Wong

Abstract

Background Transcatheter aortic valve implantation has been established as a safe and effective treatment option for patients at high or prohibitive surgical risk. However, some patients may not be suitable for the transfemoral approach due to severe iliofemoral disease or aneurysmal disease of the thoracoabdominal aorta. The aim of this case series was to evaluate the feasibility and clinical outcomes of the transaortic approach. Methods From May 2015 to June 2016, 5 patients (mean age 78.4 ± 3.9 years) with severe symptomatic aortic stenosis underwent transaortic transcatheter aortic valve implantation after a heart team discussion. They were considered to be at high surgical risk and ineligible for the transfemoral approach due to iliofemoral or thoracoabdominal aortic disease. Results A CoreValve Evolut R was successfully deployed in all 5 patients. We performed 4 right mini-parasternal incisions and one J-incision partial sternotomy. None of the patients required permanent pacemaker implantation, one required reopening of the mini-parasternal incision for postoperative bleeding. Follow-up echocardiography one month after the procedure showed improvement in the mean aortic gradient (from 63.2 to 8.3 mm Hg) and aortic valve ...Continue Reading

References

Feb 8, 2006·Circulation·John G WebbSamuel Lichtenstein
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Oct 23, 2012·The Journal of Thoracic and Cardiovascular Surgery·A Pieter KappeteinUNKNOWN Valve Academic Research Consortium-2
Apr 5, 2016·The New England Journal of Medicine·Martin B LeonUNKNOWN PARTNER 2 Investigators

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Citations

Nov 9, 2018·PloS One·Ansuk JeongByung Joon Kim

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