Document Detail


Transaortic transcatheter aortic valve implantation using Edwards SAPIEN valve: A novel approach.
MedLine Citation:
PMID:  21805602     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate feasibility and outcome of Transoartic Transcatheter Sapien valve implantation. BACKGROUND: Transcatheter Aortic valve implantation (TAVI) using the Edwards SAPIEN device (Edwards LifeScience, Irvine, CA) is usually performed via the transfemoral (TF) or transapical (TA) routes. Some patients are not be suitable for these approaches. We report our experience with the novel transaortic (TAo) approach via a partial upper sternotomy and discuss the advantages and future applications. METHODS: Between January 2008 to March 2011 193 patients with severe aortic stenosis underwent TAVI with the Edwards SAPIEN bioprosthesis at the St. Thomas' Hospital, London. 108 patients were unable to undergo a TF-TAVI and of those 17 were accepted for a TAo-TAVI on the basis of anatomy, risk, LV function and significant respiratory disease. RESULTS: The TAo-TAVI group (n=17) had more prevalent respiratory disease than the TA-TAVI group (47.0% v. 18.7%, p=0.011). Otherwise the groups were similar in demographics and history. Despite this the 30 day mortalities were not significantly different between the groups (TAo-TAVI 4.3% at 30 days versus TA-TAVI 7.7%, p=0.670). There were no significant differences in procedural complications. CONCLUSIONS: The TA-TAVI approach may not be desirable in patients with severe chest deformity, poor lung function or poor left ventricular function. TAo-TAVI via a partial sternotomy is safe and feasible in these patients. © 2011 Wiley-Liss, Inc.
Authors:
Vinnie Vinayak Bapat; Muhammed Z Khawaja; Rizwan Attia; Ashok Narayanan; Karen Wilson; Kirsty Macgillivray; Christopher Young; Jane Hancock; Simon Redwood; Martyn Thomas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-29
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Wiley-Liss, Inc.
Affiliation:
Department of Cardiothoracic Surgery and Department of Cardiology, Guy's and St. Thomas' Hospital, London, UK. vnbapat@yahoo.com.
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