title: Transapical transcatheter off-pump aortic valve implantation.
abstract: Transapical aortic valve implantation (TA-AVI) is a new minimally invasive technique for beating-heart off-pump AVI in high-risk patients. The procedure involves antegrade AVI using an oversizing technique with direct access and accurate positioning of a stent based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral minithoracotomy, placement of an epicardial pacing wire and two apical purse-string sutures. Valve implantation is performed off-pump under fluoroscopic and echocardiographic guidance with rapid ventricular pacing. This new technology is a promising alternative for selected elderly high-risk patients and seems to be associated with good outcome and a minimal stroke risk.
authors.affiliation: Department of Cardiac Surgery, Heartcenter University of Leipzig, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Kempfert
authors.forename: Sven
authors.initials: S
authors.lastname: Lehmann
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
authors.forename: Ardawan
authors.initials: A
authors.lastname: Rastan
authors.forename: Arnaud
authors.initials: A
authors.lastname: Van Linden
authors.forename: Johannes
authors.initials: J
authors.lastname: Blumenstein
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Mohr
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther