Document Detail


Rapid pacing technique for preventing ventricular tears during transapical aortic valve replacement.
MedLine Citation:
PMID:  19438784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transapical aortic valve replacement (TAVR) is emerging as an alternative to surgical aortic valve replacement in high-risk or non-operable patients with aortic stenosis. However, this approach might be associated with major bleeding complications during the removal of the introducer sheath from the left ventricular apex. We describe a simple technique to minimize this complication. METHODS: The technique consists of installing a temporary pacing Swan-Ganz catheter, using large-needle Ethibond 2-0 sutures with large pledgets for apical pursestrings, and removing the 26F sheath from the ventricular apex tension-free by rapid ventricular pacing (>150 bpm). RESULTS: We have completed 21 TAVR using rapid ventricular pacing. This technique considerably decreased the amount of apical tearing and sutures to be added at the apex. Six of 21 patients had partial ventricular tearing that was amenable to repair using rapid pacing, thereby avoiding urgent cardiopulmonary bypass. CONCLUSION: The present report describes a technique to reduce the occurrence of ventricular tears and major bleeding during TAVR.
Authors:
Eric Dumont; Josep Rodés-Cabau; Robert De LaRochellière; Jerome Lemieux; Jacques Villeneuve; Daniel Doyle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  24     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2009-05-14     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  295-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Laval Hospital, Quebec City, Canada. eric.dumont@crhl.ulaval.ca
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve Stenosis / surgery*
Cardiac Pacing, Artificial / methods*
Heart Catheterization / instrumentation
Heart Rupture / etiology,  prevention & control*
Heart Valve Prosthesis Implantation / adverse effects,  methods*
Humans
Intraoperative Care
Thoracotomy / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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