title: Bleeding from the apex during transapical transcatheter aortic valve implantation: a simple solution by balloon occlusion of the apex.
abstract: Bleeding from the apex during transapical transcatheter aortic valve implantation is a potentially catastrophic event, which may seem at first sight to be an uncontrollable circumstance. We describe a simple 'trick' to control this problem that we used successfully in 5 patients. A Fogarty occlusion aortic catheter is gently inserted into the left ventricular cavity through the apical hole used for the transcatheter procedure, the balloon is slowly inflated with 10-15 ml of saline and the catheter is slightly pulled back 1 or 2 cm. This manoeuvre immediately stops the bleeding and enables safe suturing of the apex.
authors.affiliation: Deutsches Herzzentrum Berlin, Berlin, Germany pasic@dhzb.de.
authors.forename: Miralem
authors.initials: M
authors.lastname: Pasic
authors.affiliation: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Semih
authors.initials: S
authors.lastname: Buz
authors.affiliation: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Drews
authors.affiliation: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Unbehaun
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D021721:Balloon Occlusion / Q000295:instrumentation; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D062906:Cardiac Catheters; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011677:Punctures; D013536:Suture Techniques / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Aortic valve; Complications; Heart valve; Heart valves; Percutaneous; Repair; Surgery; Transapical