A novel device for endovascular native aortic valve resection for transapical transcatheter aortic valve implantation

We developed a novel resection device to use during transapical transcatheter aortic valve implantation (TAVI) using a circular blade. We assessed the device in 15 human cadavers by transapical approach. After the resection, the aortic annulus was measured using standard probes. A careful examination of the aortic wall, left ventricular outflow tract, coronary ostia and mitral valve was performed using an endpoint checklist, developed specifically for the new device. The resection was successfully completed in 14 out of 15 (93%) cases. All the resected leaflets and debris have been successfully evaluated in 15 out of 15 (100%) cases. One case of a bicuspid valve had a prominent calcification of the median raphe. The resection tool could only perform a partial resection. The mean duration of the resection was 45 ± 30 s. The surrounding tissue examination did not reveal any injury to the anatomical structures. Endovascular resection of the native valve using transapical approach is feasible and effective. Further developments are necessary before the definitive clinical use during percutaneous aortic valve implantation.