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Off-pump apicoaortic conduit insertion for high-risk patients with aortic stenosis
1The Pensacola Heart Institute, Pensacola, FL 32504, USA.
Objectives:
Recently, we implanted an apicoaortic conduit off-pump in three high-risk patients with severe aortic stenosis.
Methods:
A muscle-coring device was utilized to create the apical outflow tract followed by insertion of a rigid apical connector. A valved conduit was then connected to the descending thoracic aorta and to the apical connector graft.
Results:
A stentless porcine bioprosthesis was implanted in two patients and a stented valve in one. The left ventricular (LV)-aortic gradients were reduced from a mean of 66 to 28 mmHg.
Conclusions:
With modification of an existing technique, apicoaortic conduit insertion can be performed safely off-pump. This technique can be applied to complex forms of LV outflow obstruction and high-risk patients.