Header

UZH-Logo

Maintenance Infos

Transapical aortic valve implantation: step by step


Walther, T; Dewey, T; Borger, M A; Kempfert, J; Linke, A; Becht, R; Falk, V; Schuler, G; Mohr, F W; Mack, M (2009). Transapical aortic valve implantation: step by step. Annals of Thoracic Surgery, 87(1):276-283.

Abstract

PURPOSE: Transapical aortic valve implantation is a new minimally invasive technique for beating heart, off-pump, aortic valve implantation in high-risk patients. DESCRIPTION: The procedure involves antegrade aortic valve implantation using an oversizing technique with direct access and accurate positioning of a stent-based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral mini-thoracotomy, epicardial pacing, and apical pursestring suture placement. Valve positioning is performed under fluoroscopic and echocardiographic guidance during rapid ventricular pacing. EVALUATION: Patient screening, especially regarding native aortic annulus diameter and pattern of calcification, is essential for success. Since imaging is crucial, implantations are optimally performed in a hybrid operative theater by an experienced team of cardiac surgeons, cardiologists, and anesthetists. CONCLUSIONS: The aim of this article is to outline the technical aspects of the new technique of minimally invasive transapical aortic valve implantation.

Abstract

PURPOSE: Transapical aortic valve implantation is a new minimally invasive technique for beating heart, off-pump, aortic valve implantation in high-risk patients. DESCRIPTION: The procedure involves antegrade aortic valve implantation using an oversizing technique with direct access and accurate positioning of a stent-based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral mini-thoracotomy, epicardial pacing, and apical pursestring suture placement. Valve positioning is performed under fluoroscopic and echocardiographic guidance during rapid ventricular pacing. EVALUATION: Patient screening, especially regarding native aortic annulus diameter and pattern of calcification, is essential for success. Since imaging is crucial, implantations are optimally performed in a hybrid operative theater by an experienced team of cardiac surgeons, cardiologists, and anesthetists. CONCLUSIONS: The aim of this article is to outline the technical aspects of the new technique of minimally invasive transapical aortic valve implantation.

Statistics

Citations

Dimensions.ai Metrics
230 citations in Web of Science®
244 citations in Scopus®
384 citations in Microsoft Academic
Google Scholar™

Altmetrics

Downloads

2 downloads since deposited on 01 Apr 2009
0 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:01 Apr 2009 18:52
Last Modified:17 Feb 2018 22:47
Publisher:Elsevier
ISSN:0003-4975
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.athoracsur.2008.08.017
PubMed ID:19101311

Download