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Ann Thorac Surg. 2009 Jan;87(1):276-83. doi: 10.1016/j.athoracsur.2008.08.017.

Transapical aortic valve implantation: step by step.

Author information

1
Universität Leipzig, Herzzentrum, Klinik für Herzchirurgie, Leipzig, Germany. walt@medizin.uni-leipzig.de

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.

[Indexed for MEDLINE]

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