title: Off-pump apicoaortic conduit insertion for high-risk patients with aortic stenosis.
abstract: OBJECTIVE
  Recently, we implanted an apicoaortic conduit off-pump in three high-risk patients with severe aortic stenosis.
  
  
  METHODS
  A muscle-coring device was utilized to create the apical outflow tract followed by insertion of a rigid apical connector. A valved conduit was then connected to the descending thoracic aorta and to the apical connector graft.
  
  
  RESULTS
  A stentless porcine bioprosthesis was implanted in two patients and a stented valve in one. The left ventricular (LV)-aortic gradients were reduced from a mean of 66 to 28 mmHg.
  
  
  CONCLUSIONS
  With modification of an existing technique, apicoaortic conduit insertion can be performed safely off-pump. This technique can be applied to complex forms of LV outflow obstruction and high-risk patients.
authors.affiliation: The Pensacola Heart Institute, Pensacola, FL 32504, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Vassiliades
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D005240:Feasibility Studies; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D012306:Risk; D015607:Stents