Direct Aortic Access for Transcatheter Self-Expanding Aortic Bioprosthetic Valves Implantation

Bruschi, Giuseppe; Marco, Federico De; Botta, Luca; Cannata, Aldo; Oreglia, Jacopo; Colombo, Paola; Barosi, Alberto; Colombo, Tiziano; Nonini, Sandra; Paino, Roberto; Klugmann, Silvio; Martinelli, Luigi

doi:10.1016/j.athoracsur.2012.04.021

Cited by 80 publications

(36 citation statements)

References 28 publications

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“…The version based on a cobalt-chromium frame can be introduced with a smaller 18F delivery system [14,18]. In addition to the transfemoral and transapical implantation routes and implantation via the subclavian artery when using small delivery systems, a transaortic implantation route via the ascending aorta was also described [19]. During implantation, the prostheses are anchored in the aortic annulus and the native aortic valve cusps are pressed against the wall of the aortic bulb.…”

mentioning

confidence: 99%

Role of Preprocedural Computed Tomography in Transcatheter Aortic Valve Implantation

Lehmkuhl

Foldyna

Haensig

et al. 2013

Fortschr Röntgenstr

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Transcatheter aortic valve implantation (TAVI) is currently considered an acceptable alternative for the treatment of patients with severe aortic stenosis and a high perioperative risk or a contraindication for open surgery. The benefit of TAVI significantly outweighs the risk of the procedure in patients requiring treatment that are not suitable for open surgery, and leads to a lower mortality in the one-year follow-up.?The absence of a direct view of the aortic root and valve remains a challenge for the transcatheter approach. While direct inspection of the aortic valve during open surgery allows an adequate prosthesis choice, it is crucial for TAVI to know the individual anatomical details prior to the procedure in order to assure adequate planning of the procedure and proper prosthesis choice and patient selection. Among the imaging modalities available for the evaluation of patients prior to TAVI, computed tomography (CT) plays a central role in patient selection. CT reliably visualizes the dimensions of the aortic root and allows a proper choice of the prosthesis size. The morphology of the access path and relevant comorbidities can be assessed. The present review summarizes the current state of knowledge regarding the value of CT in the evaluation of patients prior to TAVI. Key Points: Citation Format:

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confidence: 99%

Role of Preprocedural Computed Tomography in Transcatheter Aortic Valve Implantation

Lehmkuhl

Foldyna

Haensig

et al. 2013

Fortschr Röntgenstr

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“…8 Direct aortic access can be obtained by mini-sternotomy as well as with a right anterior mini-thoracotomy. 9 The direct aortic approach has advantage of overcoming challenging vascular disease, and avoids the risk of dislodging atherosclerotic plaque during procedure through the aorta that may cause distal embolism and subsequent stroke. 9 Cannula access is technically easy and hemorrhage or late pseudoaneurysm risk is relatively low.…”

Section: Discussionmentioning

confidence: 99%

“…9 The direct aortic approach has advantage of overcoming challenging vascular disease, and avoids the risk of dislodging atherosclerotic plaque during procedure through the aorta that may cause distal embolism and subsequent stroke. 9 Cannula access is technically easy and hemorrhage or late pseudoaneurysm risk is relatively low. 8 Our patient tolerated wound pain very well and showed early respiratory and physical recovery without any adverse event.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Implantation Using CoreValve by Transaortic Approach

Park

Shim

et al. 2013

J Lipid Atheroscler

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This is an Open Access article distributed under the terms of the creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction: Transcatheter aortic valve implantation (TAVI) is now considered as an alternative treatment option for severe aortic stenosis (AS) patients who cannot undergo surgical aortic valve replacement (AVR). Case report: We describe the first Korean case of transaortic TAVI with mini-sternotomy using CoreValve. A 83-year-old woman with severe AS and recent history of non-ST elevation myocardial infarction was referred to our institution for TAVI intervention. There was no amenable peripheral vascular access for transfemoral or trans-subclavian approach. Considering the relatively high procedural risk of transapical approach in this patient, we performed transaortic TAVI with mini-sternotomy. Conclusion:The present case suggests transaortic approach may be an effective and safe strategy for TAVI in high risk severe AS patients without eligible femoral or subclavian access routes.

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“…Numerous observational clinical studies, national registries 1 and controlled randomized clinical trials 2,3 demonstrated the safety and effectiveness of transcatheter valve implantation. The first access for TAVI was the retrograde approach from the femoral artery, today several choices for access route are available, the subclavian access 4 , the transapical or direct aortic approaches 5,6,7 .…”

Section: Introductionmentioning

confidence: 99%

“…A basal ascending aorta aortography was performed to evaluate location of proximal graft anastomosis before opening the pericardium and to measure the distance between the aortic annulus and the selected entry site, and evaluate coaxial trajectory to aortic annulus (Figure 1 E). Direct aortic cannulation was performed with the Seldinger technique through double purse-string sutures, the technique as been previously described 5,6 . A 29 mm CoreValve was then carefully introduced and retrogradely implanted under angiographic and fluoroscopic guidance (Figure 1 F).…”

Section: Introductionmentioning

confidence: 99%

Direct Aortic CoreValve Implantation via Right Anterior Thoracotomy in a Patient with Patent Bilateral Mammary Artery Grafts and Aortic Arch Chronic Dissection

Bruschi

Fratto

Colombo

et al. 2015

ICFJ

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<p>Direct aortic trans-catheter aortic valve implantation is an alternative approach to treat high risk for surgery patients affected by severe aortic stenosis and concomitant peripheral vascular disease.</p><p>We describe a case of direct aortic CoreValve implantation made via a right anterior thoracotomy in a 78-year-old male affected by severe aortic stenosis and severe peripheral vasculopathy, who previously underwent coronary artery bypass grafting, with patent bilateral mammary artery grafts and chronic aortic arch dissection.</p>

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Direct Aortic Access for Transcatheter Self-Expanding Aortic Bioprosthetic Valves Implantation

Cited by 80 publications

References 28 publications

Role of Preprocedural Computed Tomography in Transcatheter Aortic Valve Implantation

Role of Preprocedural Computed Tomography in Transcatheter Aortic Valve Implantation

Transcatheter Aortic Valve Implantation Using CoreValve by Transaortic Approach

Direct Aortic CoreValve Implantation via Right Anterior Thoracotomy in a Patient with Patent Bilateral Mammary Artery Grafts and Aortic Arch Chronic Dissection

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