When operable patients become inoperable: conversion of a surgical aortic valve replacement into transcatheter aortic valve implantation.
ABSTRACT Transcatheter aortic valve implantation (TAVI) is a relatively new treatment option for inoperable patients with severe aortic stenosis (AS). This case describes how a planned conventional surgical aortic valve replacement (AVR) on a 73-year-old woman was successfully converted to a TAVI procedure. On extracorporal circulation it was reconized that the aortic annulus, the coronary ostiae and the proximal part of the ascending aorta were severely calcified making valve implantation impossible. Surgical closure without valve substitution was estimated to be associated with a high risk of mortality due to the imparied left ventricular function. Consequently, TAVI was performed with a CoreValve ReValving System prosthesis. The delivery of the valve prosthesis was made through the ascending part of aorta, proximal of the cannulation of aorta. Positioning of the valve prosthesis was made under visual guidance, and the prosthesis was sutured to the ascending aorta. With some manipulation of the prosthesis it was possible to suture the aorta circumferentially around the fully expanded upper part of the prosthesis. Post-procedurally the patient recovered successfully, with improved function capacity, aortic valve area and left ventricle function.
Full-textDOI: · Available from: Lars Sondergaard, Sep 26, 2014
07/2012; 1(2):172-5. DOI:10.3978/j.issn.2225-319X.2012.07.05
The Journal of thoracic and cardiovascular surgery 04/2012; 144(3):728-31. DOI:10.1016/j.jtcvs.2012.03.056 · 3.99 Impact Factor
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ABSTRACT: We describe a bailout procedure when surgical aortic-valve replacement was not possible due to severe calcification of the ascending aorta and the root and a very small annulus. A 21-mm CoreValve Revalving prosthesis was inserted via the aortotomy in the presence of a mitral prosthesis.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 11/2010; 39(4):589-90. DOI:10.1016/j.ejcts.2010.07.044 · 2.81 Impact Factor