title: The third hand--a simple but useful tool for holding the sheath during transapical transcatheter aortic valve implantation.
abstract: Transapical aortic valve implantation is an evolving technology for treating high-risk patients with symptomatic aortic stenosis. The transition to a catheter based implantation technique inherits one fundamental change: the native valve stays in place and is no longer removed. The selection of the correct plane of the aortic annulus, therefore, is mandatory. In addition, exact alignment of the sheath and catheters according to axis of the ascending aorta is imperative for correct implantation. That is why any additional movements have to be avoided. To aid in better workflow, we developed an easy-to-use cheap holder for the introduction sheath. By using a rigid table mount instrument holder the sheath can easily be fixed in the desired orientation, abolishing any movement and reducing the X-ray load to the implanting surgeon.
authors.affiliation: Department of Cardiac Surgery, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Wilfried.Wisser@meduniwien.ac.at
authors.forename: Wilfried
authors.initials: W
authors.lastname: Wisser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control; D011829:Radiation Dosage; D015641:Radiography, Interventional; D013525:Surgical Instruments; D013908:Thoracotomy; D016896:Treatment Outcome