title: An Early Canadian Experience With the Correx Automated Coring and Apical Connector Device for Aortic Valve Bypass.
abstract: OBJECTIVE
  Aortic valve replacement is the standard of care for severe, symptomatic aortic valve stenosis (AS); however, anatomy or pre-existing comorbidities may preclude conventional or alternative transcatheter approaches. Aortic valve bypass (AVB) may be performed as a salvage procedure for the relief of symptomatic aortic stenosis in patients who are not suitable candidates for aortic valve replacement.
  
  
  METHODS
  At our institution, seven patients underwent AVB using the Correx automated coring and apical connector system. All patients had severe AS with New York Heart Association functional class 3 symptoms and were not candidates for conventional or transcatheter approaches. Via a left anterolateral thoracotomy to access the descending aorta and left ventricular apex, we used the Correx system (Correx, Waltham, MA USA) to anastomose a valve conduit to the left ventricular apex proximally and the descending aorta distally. Three patients required cardiopulmonary bypass.
  
  
  RESULTS
  In all seven patients, the automated coring and apical connector was successfully deployed. There were two in-hospital deaths in this series. Immediately postoperatively and at 3 months, there was a significant reduction in mean and peak valve gradients, and all surviving patients performed at New York Heart Association functional class 1.
  
  
  CONCLUSIONS
  Aortic valve bypass seems to be an acceptable alternative for the treatment of severe AS in high-risk patients who are not candidates for aortic valve replacement. The Correx automated system may improve the clinical applicability and surgical reproducibility of AVB in appropriately selected patients in which conventional or transcatheter aortic valve replacement is not a feasible options.
authors.affiliation: From the *Schulich School of Medicine, Western University, London, ON Canada; and †Division of Cardiac Surgery, University of Western Ontario, Lawson Health Research Institute, London, ON Canada.
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Al-Amodi
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Tarola
authors.forename: Hamad F
authors.initials: HF
authors.lastname: Alhabib
authors.forename: Corey
authors.initials: C
authors.lastname: Adams
authors.forename: Linrui Ray
authors.initials: LR
authors.lastname: Guo
authors.forename: Bob B
authors.initials: BB
authors.lastname: Kiaii
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002170:Canada; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome