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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
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Related Experiment Video

Updated: Feb 15, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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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.

The Annals of Thoracic Surgery
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Transcatheter aortic valve implantation is feasible in select patients with aortic aneurysms when used as a bailout strategy. Careful preoperative assessment and specific techniques are crucial for successful outcomes.

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Aortic Disease

Background:

  • Transcatheter aortic valve implantation (TAVI) is generally contraindicated in patients with aneurysmatic aortopathy.
  • Aneurysmal aortopathy presents unique challenges for TAVI procedures.
  • TAVI may be considered as a bailout strategy in carefully selected patients.

Purpose of the Study:

  • To evaluate the feasibility and safety of TAVI in patients with complex aneurysmal aortic morphology.
  • To describe the technical aspects and safeguards employed during TAVI in this high-risk population.

Main Methods:

  • Meticulous preoperative assessment of aortic measurements.
  • Valve selection tailored to complex aortic anatomy.
  • Retrograde access via the right subclavian artery, serving as a backup cannulation site.
  • Transcatheter aortic valve implantation performed via the transapical route.

Main Results:

  • TAVI in complex aneurysmal aortic morphology is feasible in highly selected patients.
  • The described approach incorporates specific safeguards for managing aortic pathology during TAVI.
  • Initial experience suggests this can be a viable bailout strategy.

Conclusions:

  • Comprehensive preoperative evaluation is critical for successful TAVI in patients with aneurysmal aortopathy.
  • The transapical approach with specific access strategies can be effective.
  • This technique offers a potential bailout option for selected patients with challenging aortic anatomy.