Transapical Transcatheter Aortic Valve Implantation in Humans

• DOI: 10.1161/circulationaha.106.632927
• Publication Date: 2006-08-02T07:49:13Z
• Authors: Samuel V. Lichten...; Anson Cheung; Jian Ye; Christopher R. Th...; Ronald G. Carere; Sanjeevan Pasupati; John G. Webb
• Keywords: Aortic valvuloplasty; Cardiac skeleton

Aortic valve replacement with cardiopulmonary bypass is currently the treatment of choice for symptomatic aortic stenosis but carries a significant risk morbidity and mortality, particularly in patients comorbidities. Recently, percutaneous transfemoral implantation has been proposed as viable alternative selected patients. We describe our experience new, minimally invasive, catheter-based approach to via left ventricular apical puncture without or sternotomy.A anterolateral intercostal incision used expose apex. Direct needle apex allows introduction hemostatic sheath into ventricle. The prosthesis, constructed from stainless steel stent an attached trileaflet equine pericardial valve, crimped onto valvuloplasty balloon. prosthetic balloon catheter are passed over wire Positioning within annulus confirmed by fluoroscopy, aortography, echocardiography. Rapid pacing reduce cardiac output while inflated, deploying prosthesis annulus. Transapical was successfully performed 7 whom surgical deemed excessive because Echocardiographic median area increased 0.7 +/- 0.1 cm2 (interquartile range) 1.8 0.8 range). There were no intraprocedural deaths. At follow up 87 56 days, 6 remain alive well.This initial suggests that transapical feasible stenosis.