title: Prominent septal hypertrophy: a contra-indication for transapical aortic valve implantation?
abstract: We report a case of transapical aortic valve implantation in a patient with severe left ventricular hypertrophy. The valve was deployed but failed to attain stable seating because of a hypertrophied septal ridge encroaching on the landing zone. Moderate perivalvar insufficiency was also noted. A second valve was deployed in an attempt to achieve stable seating and correct the perivalvar leak. This was unsuccessful and the two-valve complex embolized into the ascending aorta. The valves were moved and seated in the proximal descending thoracic aorta. The technical issues of transapical aortic valve implantation in patients with severe left ventricular hypertrophy are reviewed.
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada.
authors.forename: Darrin M
authors.initials: DM
authors.lastname: Payne
authors.forename: Josep
authors.initials: J
authors.lastname: Rodes-Cabau
authors.forename: Daniel
authors.initials: D
authors.lastname: Doyle
authors.forename: Robert
authors.initials: R
authors.lastname: De Larochellière
authors.forename: Jacques
authors.initials: J
authors.lastname: Villeneuve
authors.forename: Eric
authors.initials: E
authors.lastname: Dumont
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis; D008297:Male; D054088:Ventricular Septum / Q000473:pathology*