Direct aortic transcatheter valve implantation via mini-thoracotomy using the Medtronic CoreValve.
Transcatheter aortic valve implantation using the Medtronic CoreValve is a well-established procedure. Although previously carried out only through the common femoral artery, today it is possible to perform the procedure through different arterial alternative access sites. A direct aortic approach through the ascending aorta could be carried out via a right anterior mini-thoracotomy in the second intercostal space. The pericardium is opened to expose the aorta. Two purse-string sutures are then placed on the ascending aorta and a standard retrograde CoreValve implantation is performed with the standard delivery system. Advantages, contraindications, surgical technique and results are discussed.
'A. De Gasperis' Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Milan, Italy.
Giuseppe
G
Bruschi
Luca
L
Botta
Federico
F
De Marco
Paola
P
Colombo
Sandra
S
Nonini
Silvio
S
Klugmann
Luigi
L
Martinelli
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D000075202:Contraindications; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D010348:Patient Care Team; D018579:Patient Selection; D011474:Prosthesis Design; D013908:Thoracotomy / Q000379:methods*; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*
Aortic stenosis; Aortic valve; Direct aortic valve implantation; Minimally invasive; Thoracotomy; transcatheter valve implantation