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Updated: Feb 15, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Transcatheter Aortic Valve Implantation in Morphologically Complex Root Aneurysms
Markus Mach1, Bernhard Winkler1, David Santer1
1Department of Cardiovascular Surgery, Hospital Hietzing and Karl Landsteiner Institute for Cardiovascular Research, Vienna, Austria.
Abstract:
Performing transcatheter aortic valve implantation in the presence of aneurysmatic aortopathy is widely contraindicated but needs to be taken into account as a bailout strategy in selected patients. Deliberate preoperative assessment of measurements becomes the crucial key element in this context. After meticulous valve selection, retrograde access is obtained through the right subclavian artery additionally serving as a backup arterial cannulation site in case of conversion. Transcatheter aortic valve implantation is then performed through the transapical route. Transcatheter aortic valve implantation in complex aneurysmatic aortic morphology is feasible in highly selected patients after comprehensive preoperative evaluation. The present article describes our initial experience, safeguards, and technical details.
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