Transcatheter aortic valve insertion in patients with hostile ascending aorta calcification

The Journal of Thoracic and Cardiovascular Surgery
Akio NakasuDavid R Holmes

Abstract

Calcification of the ascending aorta complicates aortic valve replacement. Transcatheter aortic valve replacement is an alternative procedure in this situation, but it requires manipulation through the hostile area in the ascending aorta. We reviewed our transcatheter aortic valve insertion experience to better understand the surgical mortality risk of valve insertion in patients with extensive calcification of the ascending aorta. We retrospectively reviewed the records of 665 consecutive patients who received transcatheter aortic valve insertion from November 2008 through December 2015. We defined a hostile ascending aorta on the basis of preoperative computed tomography scan documenting significant aortic calcification that the surgeon believed precluded safe aortic cross-clamp application. There were 36 patients (5%) who met our definition of a hostile ascending aorta (hostile aorta group) and 629 (95%) who did not (control group). Surgical mortality occurred in 2 patients (6%) in the hostile aorta group and in 18 (3%) in the control group (P = .296). There were no strokes in the hostile aorta group, whereas there were 15 (2%) in the control group (P = 1.00). There was no difference in mortality at 3 years for patients in t...Continue Reading

Citations

Apr 13, 2021·The Journal of Thoracic and Cardiovascular Surgery·Jean PorterieSiamak Mohammadi

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