title: Transaortic transcatheter aortic valve implantation using the Edwards Sapien valve.
abstract: Transcatheter aortic valve implantation using Edwards Sapien Valve can be carried out through the ascending aorta. In the majority of patients, the ascending aorta is approached through a partial upper J-sternotomy. The sternotomy extends into the right second or third right intercostal space. The pericardium is opened in midline and the top of the ascending aorta is exposed. Two purse-string sutures are then placed on the ascending aorta and Sapien valve implantation is carried out using the Ascendra delivery system with the valve mounted in a reverse fashion to that of a transapical approach. Owing to the familiarity of the surgeons with exposing the aorta and placing purse-strings for cannulation, this procedure is within the comfort zone of surgeons compared with the transapical approach. Advantages, contra--indications, surgical technique and results are also discussed.
authors.affiliation: Department of Cardiothroacic Surgery, St. Thomas' Hospital, London, UK.
authors.forename: Vinnie Vinayak
authors.initials: VV
authors.lastname: Bapat
authors.forename: Rizwan
authors.initials: R
authors.lastname: Attia
keywords: Aortic stenosis; Aortic valve; Minimally invasive; Transaortic; Transcatheter