Transseptal control of the difficult aortic annulus

Area of Science:

• Cardiovascular Surgery
• Infective Endocarditis
• Prosthetic Valve Surgery

Background:

• Extensive erosive endocarditis poses challenges for aortic root repair.
• Secure prosthetic fixation to the interventricular septum is crucial for successful outcomes.
• Mycotic ventricular septal defects can complicate aortic root management.

Purpose of the Study:

• To describe a novel technique for prosthetic fixation in aortic root reconstruction.
• To evaluate the efficacy and safety of transseptal suture fixation.
• To recommend an improved surgical approach for complex endocarditis cases.

Main Methods:

• Transseptal suture fixation of aortic root prostheses.
• Utilizing a pulmonary infundibular approach for septal access.
• Comparison with traditional left ventricular outflow tract suture methods.

Main Results:

• The transseptal approach facilitates secure prosthetic fixation to the interventricular septum.
• This technique potentially reduces surgical trauma compared to intraventricular methods.
• Early adoption may prevent complications associated with difficult septal suture placement.

Conclusions:

• Transseptal suture fixation is a viable and recommended technique for aortic root prostheses.
• This method enhances secure fixation in extensive erosive endocarditis.
• It offers a safer alternative to left ventricular outflow tract approaches.