Transapical transcatheter off-pump aortic valve implantation

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Medical Devices

Background:

• Aortic valve implantation (AVI) is crucial for treating aortic stenosis.
• Minimally invasive techniques are sought to reduce risks in high-risk patients.
• Transapical aortic valve implantation (TA-AVI) presents a novel off-pump approach.

Purpose of the Study:

• To describe the technique of transapical aortic valve implantation (TA-AVI).
• To evaluate the feasibility and initial outcomes of TA-AVI in high-risk patients.
• To assess the safety profile, including stroke risk, of this minimally invasive procedure.

Main Methods:

• TA-AVI performed as a beating-heart, off-pump procedure.
• Utilized an antegrade implantation technique with oversizing and direct access.
• Employed fluoroscopic and echocardiographic guidance with rapid ventricular pacing.

Main Results:

• Successful implantation of stent-based transcatheter xenografts.
• Procedure performed with direct access and accurate positioning.
• Associated with good outcomes and minimal stroke risk in selected patients.

Conclusions:

• TA-AVI is a promising minimally invasive alternative for elderly, high-risk patients.
• The technique allows for off-pump valve implantation with accurate stent-graft placement.
• Early results suggest favorable outcomes and a low risk of stroke.