Summary
Background
Transcatheter aortic valve implantation is a procedure reserved for patients with severe aortic stenosis and high operative risk. Minimization of surgical trauma and avoidance of cardiopulmonary bypass makes this procedure interesting for bail-out situations of unexpectedly inoperable patients.
Methods
We describe two cases of transcatheter aortic valve implantation via transaortic access in patients with intraoperatively diagnosed contraindications to conventional aortic valve replacement.
Results
In the first case, the procedure was performed via median sternotomy in order to allow central cannulation for extracorporeal circulation in a patient without access vessels for peripheral cannulation. In the second patient, the procedure was performed in a minimally invasive fashion via upper partial sternotomy. Both procedures were performed using a transapical sheath and an upside down mounted transcatheter aortic valve prosthesis.
Conclusions
Transaortic valve implantation can be successfully used for unexpectedly inoperable patients even without previous evaluation for transcatheter valve implantation.
This is a preview of subscription content, log in via an institution to check access.
References
Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Williams M, Dewey T, Kapadia S, Babaliaros V, Thourani VH, Corso P, Pichard AD, Bavaria JE, Herrmann HC, Akin JJ, Anderson WN, Wang D, Pocock SJ, PARTNER Trial Investigators. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011 Jun 9;364(23):2187–98 (Epub 2011 Jun 5).
Walther T, Kempfert J, Rastan A, Borger MA, Linke A, Ender J, Schuler G, Mohr FW. Transapical aortic valve implantation at 3 years. J Thorac Cardiovasc Surg. 2012 Feb;143(2):326–31.
Buz S, Pasic M, Unbehaun A, Drews T, Dreysse S, Kukucka M, Mladenow A, Hetzer R. Trans-apical aortic valve implantation in patients with severe calcification of the ascending aorta. Eur J Cardiothorac Surg. 2011;40(2):463–8.
Wisser W, Gabriel H, Mächler H, Maier R, Maurer E, et al. Position Paper. Terms of agreement between the Austrian Society of Cardiology and the Austrian Society of Thoracic and Cardiovascular Surgery on transcatheter heart valve interventions. Eur Surg. 2012;44(1):33–40.
Latsios G, Gerckens U, Grube E. Transaortic transcatheter aortic valve implantation: a novel approach for the truly “no-access option” patients. Catheter Cardiovasc Interv. 2010 Jun 1;75(7):1129–36.
Conflict of interest
The authors declare that there is no actual or potential conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bonaros, N., Bartel, T., Friedrich, G. et al. Transcatheter aortic valve implantation via transaortic access: a bail-out strategy in unexpectedly inoperable patients. Eur Surg 44, 416–418 (2012). https://doi.org/10.1007/s10353-012-0170-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10353-012-0170-z