How to Perform a Late Surgical Explantation of a CoreValve Aortic Bioprothesis

Abstract

As transcatheter techniques expand to younger patients, cardiac surgeons need to know a safe surgical technique to extract these kinds of prostheses. We describe here an adequate surgical strategy for the explantation of a CoreValve prosthesis that was implanted more than 5 years previously.

Surgical Explantation of a Transcatheter-Implanted Aortic Valve Prosthesis Is Feasible and Easy

“…Our group recently described an adequate surgical technique to explant TAVI-placed prostheses [1]. In this report, we have provided videos demonstrating the ease of the endarterectomy, and we confirmed that there were no adhesions at the coronary ostia, thereby facilitating explantation of the prosthesis without the need for aortic root replacement.…”

“…Therefore, it would be very helpful to know a safe and easy way to perform it. We have described a surgical technique for this operation [1]. In this report we show that this technique can be used routinely, and we provide videos of the operation.…”

“…Surgical explantation of the CoreValve was indicated, offered, and accepted by the patient. He underwent the surgical procedure, which used an appropriate and easy operative technique, as recently described by our group [1]. Videos 1, 2, and 3 demonstrate the surgical findings and operative technique.…”

Easy surgical explantation technique for self-expanding transcatheter aortic valve: ‘lasso technique’

“…There have been several techniques to explant TAVR prosthesis safely and effectively, avoiding aortic root injury. Hernandez-Vaquero et al [ 3 , 4 ] used an endarterectomy spatula for meticulous dissection and Valdis et al [ 5 ] used a heavy snaring suture to collapse the prosthesis and facilitate explantation. To create a better surgical field for meticulous dissection, we used 2 consecutive 2–0 polyester snaring sutures, which were fastened by tourniquets.…”