Intraoperative monitoring with transesophageal real-time three-dimensional echocardiography during transapical prosthetic aortic valve implantation.
Degenerative aortic stenosis is the most common valvulopathy in Europe. In symptomatic patients, aortic valve replacement with a prosthesis substantially improves prognosis. However, a high percentage of candidates for valve replacement surgery are rejected because of the high risk of serious complications. In recent years, percutaneous and minimally invasive surgical techniques have been developed for the transcatheter implantation of prosthetic aortic valves. These developments could lead to an increase in the number of interventions carried out in high-risk patients as the positive effect of treatment on prognosis would be retained while the complication rate would be reduced. We describe the use of transesophageal echocardiography (TEE) for intraoperative monitoring in 21 patients who underwent transcatheter aortic valve replacement using an transapical approach, and report morphologic findings, hemodynamic results, and complications observed. We propose a standard approach to imaging, in which real-time three-dimensional TEE is used to provide additional information during intraoperative monitoring of transapical transcatheter aortic valve replacement.
Marcos-Alberca
Pedro
P
Unidad de Imagen Cardiovascular, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. pmarcosa.hcsc@salud.madrid.org
Zamorano
José Luis
JL
Sánchez
Tibisay
T
Maroto
Luis
L
Pérez de Isla
Leopoldo
L
Almería
Carlos
C
Macaya
Carlos
C
Rodríguez
Enrique
E
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D003199:Computer Systems; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*