Article

When operable patients become inoperable: conversion of a surgical aortic valve replacement into transcatheter aortic valve implantation.

Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
Interactive Cardiovascular and Thoracic Surgery (Impact Factor: 1.11). 09/2009; 9(5):837-9. DOI: 10.1510/icvts.2009.211144
Source: PubMed

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.

Download full-text

Full-text

Available from: Lars Sondergaard, Sep 26, 2014
0 Followers
 · 
104 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper deals with the significance of the envelope detection operation, commonly performed on the output signals generated by a sonar imaging system, before of the visualisation. Although imaging systems are often linear processes, envelope detection destroys phase information, thus producing a nonlinear contribution. Within this paper, the relative importance of the nonlinear contribution is evaluated, in a general way, and its incidence in real sonar systems has been analysed, in a practical way, by performing several simulations. Simulations results have pointed out a considerable incidence of such nonlinearities on the quality of obtained images
    Autonomous Underwater Vehicle Technology, 1996. AUV '96., Proceedings of the 1996 Symposium on; 07/1996
  • [Show abstract] [Hide abstract]
    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
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We present a case of successful implantation of the Corevalve aortic bioprosthesis via the left subclavian artery in a patient with a patent internal mammary graft to the left anterior descending artery. This unusual choice of access, in the presence of adequate caliber femoral arteries, was justified by the presence of mobile thrombi in the abdominal aorta. The risk of thrombus dislodgement and subsequent major cholesterol embolization was deemed higher than the risk of coronary ischemia due to the large caliber sheath required for transcatheter aortic valve implantation. This case shows that presence of a LIMA to LAD graft is not an absolute contraindication for homolateral subclavian access and that the procedure is feasible and relatively safe provided that certain rules are followed.
    Catheterization and Cardiovascular Interventions 02/2011; 77(3):430-4. DOI:10.1002/ccd.22417 · 2.40 Impact Factor