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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Transapical minimally invasive aortic valve implantation: multicenter experience
Thomas Walther1, Paul Simon, Todd Dewey
1University Leipzig, Heartcenter, Department of Cardiac Surgery, Leipzig, Germany. walt@medizin.uni-leipzig.de
Circulation
|September 14, 2007
Summary
Minimally invasive transapical aortic valve implantation (TAP-AVI) offers safe, early success for high-risk aortic stenosis patients. Further studies are needed to assess long-term outcomes and expand its applications.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Aortic stenosis poses significant risk, especially for high-risk patients.
- Minimally invasive surgical options are crucial for this patient group.
Purpose of the Study:
- To evaluate the initial multicenter outcomes of transapical aortic valve implantation (TAP-AVI).
- To assess the safety and efficacy of TAP-AVI in high-risk patients with aortic stenosis.
Main Methods:
- The study involved 59 high-risk patients undergoing TAP-AVI using a balloon-expandable stent (Edwards SAPIEN THV).
- Procedures were performed via minithoracotomy on a beating heart, with or without extracorporeal circulation.
- Fluoroscopic and echocardiographic guidance were utilized for valve positioning and assessment.
Main Results:
- Successful TAP valve positioning was achieved in 53 patients; 4 required conversion to sternotomy.
- No coronary artery obstruction or prosthesis migration occurred; all valves demonstrated good hemodynamic function.
- In-hospital mortality was 13.6% (8 patients), unrelated to valve dysfunction. Actuarial survival was 75.7% at follow-up.
Conclusions:
- Transapical aortic valve implantation (TAP-AVI) is a safe procedure with promising early results for high-risk patients.
- Long-term valve performance and expanded applications of TAP-AVI require further investigation.
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