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OBJECTIVE:To Assess the feasibility and safety of transcatheter aortic valve Implantation on a beating heart through the left ventricular apex
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Anson W. Cheung1, Jian Ye1, Samuel V. Lictenstein1, Sanjeevan Pausupati2, Ron Carere2, Christopher R. Thompson2, Ajay Sinhal2, John G. Webb2.
1Cardiothoracic Surgery, St. Paul's Hospital, Vancouver, BC, Canada, 2Cardiology, St. Paul's Hospital, Vancouver, BC, Canada.
METHODS: Twenty-two non surgical candidates for open aortic valve replacement or transfemoral transcatheter aortic valve implantation underwent transapical aortic valve implantations. A left mini-thoracotomy approach is used. LV apex is then punctured. Balloon valvuloplasty and valve implantion was carried out in an antegrade fashion. Equine and bovine pericardial stent valves were deployed under TEE and fluoroscopic guidance.
RESULTS:Successful balloon valvuloplasty and transpical aortic valve implantation in all patients. One intraoperative death (5%) and 30 day mortality was 22%. Early hemodynamics was excellent.
CONCLUSIONS: Early results of transapical aortic valve implantation is encouraging. For non surgical candidates, it represents a novel approach to treat aortic stensosis.
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