Successful use of a left ventricular apical access and closure device for second-generation transapical aortic valve implantation
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Successful use of a left ventricular apical access and closure device for second-generation transapical aortic valve implantation. / Conradi, Lenard; Seiffert, Moritz; Shimamura, Kazuo; Schirmer, Johannes; Blankenberg, Stefan; Reichenspurner, Hermann; Diemert, Patrick; Treede, Hendrik.
in: THORAC CARDIOV SURG, Jahrgang 62, Nr. 6, 09.2014, S. 498-502.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Successful use of a left ventricular apical access and closure device for second-generation transapical aortic valve implantation
AU - Conradi, Lenard
AU - Seiffert, Moritz
AU - Shimamura, Kazuo
AU - Schirmer, Johannes
AU - Blankenberg, Stefan
AU - Reichenspurner, Hermann
AU - Diemert, Patrick
AU - Treede, Hendrik
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2014/9
Y1 - 2014/9
N2 - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become routine for the treatment of high-risk patients with aortic stenosis. We assessed safety and feasibility of a left ventricular apical access and closure device combined with second-generation transapical (TA) TAVI transcatheter heart valves (THV).METHODS AND RESULTS: Three elderly, comorbid patients (logEuroSCORE I 13.0-31.1%) received transapical aortic valve implantation (TA-AVI) via the Apica ASC device (Apica Cardiovascular Ltd., Galway, Ireland) using second-generation THV (Medtronic Engager [Medtronic 3F Therapeutics, Santa Ana, California, United States], JenaValve [JenaValve Technology GmbH, Munich, Germany], Symetis Acurate [Symetis S.A., Ecublens, Switzerland]). Access was gained using a non-rib-spreading technique and a novel access and closure device. THV deployment was successful with excellent hemodynamic outcome (no PVL, n = 2; trace PVL, n = 1; mean transvalvular gradients, 5-19 mm Hg) and complete apical hemostasis. No periprocedural major adverse events occurred and Valve Academic Research Consortium-2-defined composite end point of device success was met in all cases.CONCLUSION: Safety and feasibility of TA-AVI using the ASC device with second-generation THV was demonstrated. Combining latest available technology is a major step toward improved functional outcome and decreased surgical trauma in TA-AVI. Potentially, technical enhancements may eventually pave the way toward a fully percutaneous TA-AVI procedure.
AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become routine for the treatment of high-risk patients with aortic stenosis. We assessed safety and feasibility of a left ventricular apical access and closure device combined with second-generation transapical (TA) TAVI transcatheter heart valves (THV).METHODS AND RESULTS: Three elderly, comorbid patients (logEuroSCORE I 13.0-31.1%) received transapical aortic valve implantation (TA-AVI) via the Apica ASC device (Apica Cardiovascular Ltd., Galway, Ireland) using second-generation THV (Medtronic Engager [Medtronic 3F Therapeutics, Santa Ana, California, United States], JenaValve [JenaValve Technology GmbH, Munich, Germany], Symetis Acurate [Symetis S.A., Ecublens, Switzerland]). Access was gained using a non-rib-spreading technique and a novel access and closure device. THV deployment was successful with excellent hemodynamic outcome (no PVL, n = 2; trace PVL, n = 1; mean transvalvular gradients, 5-19 mm Hg) and complete apical hemostasis. No periprocedural major adverse events occurred and Valve Academic Research Consortium-2-defined composite end point of device success was met in all cases.CONCLUSION: Safety and feasibility of TA-AVI using the ASC device with second-generation THV was demonstrated. Combining latest available technology is a major step toward improved functional outcome and decreased surgical trauma in TA-AVI. Potentially, technical enhancements may eventually pave the way toward a fully percutaneous TA-AVI procedure.
KW - Aged, 80 and over
KW - Aortic Valve/physiopathology
KW - Aortic Valve Stenosis/diagnosis
KW - Cardiac Catheterization/adverse effects
KW - Feasibility Studies
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Hemodynamics
KW - Hemorrhage/etiology
KW - Hemostatic Techniques/adverse effects
KW - Humans
KW - Male
KW - Prosthesis Design
KW - Punctures
KW - Severity of Illness Index
KW - Treatment Outcome
U2 - 10.1055/s-0034-1381743
DO - 10.1055/s-0034-1381743
M3 - SCORING: Journal article
C2 - 24911901
VL - 62
SP - 498
EP - 502
JO - THORAC CARDIOV SURG
JF - THORAC CARDIOV SURG
SN - 0171-6425
IS - 6
ER -