title: Automated coring and apical connector insertion device for aortic valve bypass surgery.
abstract: OBJECTIVE
  The technical difficulty of performing the left ventricular apical anastomosis has limited the adoption of aortic valve bypass surgery for the treatment of aortic stenosis. We report the successful use of an automated coring and apical connector device to perform aortic valve bypass surgery.
  
  
  METHODS
  A 74-year-old man, with a history of prior coronary bypass surgery with patent grafts and a porcelain ascending aorta, presented with symptomatic critical aortic stenosis. Through a left anterolateral thoracotomy, a valved conduit was anastomosed to the descending thoracic aorta. The automated coring and apical connector insertion device was used to core a plug of apical myocardium and simultaneously insert an 18-mm apical connector into the left ventricular apex.
  
  
  RESULTS
  There were no procedural complications, cardiopulmonary bypass was not used, and estimated blood loss was minimal. The patient was discharged on postoperative day 5, and at 3-month follow-up demonstrated significant clinical and hemodynamic improvement.
  
  
  CONCLUSIONS
  The automated coring and apical connector insertion device facilitated the safe and effective performance of aortic valve bypass surgery.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Corey
authors.initials: C
authors.lastname: Adams
authors.forename: Linrui Ray
authors.initials: LR
authors.lastname: Guo
authors.forename: Philip M
authors.initials: PM
authors.lastname: Jones
authors.forename: Christopher
authors.initials: C
authors.lastname: Harle
authors.forename: John W
authors.initials: JW
authors.lastname: Brown
authors.forename: James S
authors.initials: JS
authors.lastname: Gammie
authors.forename: Bob
authors.initials: B
authors.lastname: Kiaii
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001013:Aorta, Thoracic / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D001331:Automation; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male