Direct Transatrial Transcatheter SAPIEN Valve Implantation Through Right Minithoracotomy in a Degenerated Mitral Bioprosthetic Valve Giuseppe Bruschi,

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Direct Transatrial Transcatheter SAPIEN Valve Implantation Through Right Minithoracotomy in a Degenerated Mitral Bioprosthetic Valve Giuseppe Bruschi, MD, FESC, Alberto Barosi, MD, Paola Colombo, MD, PhD, Luca Botta, MD, Jacopo Oreglia, MD, Federico De Marco, MD, Roberto Paino, MD, Silvio Klugmann, MD, Luigi Martinelli, MD The Annals of Thoracic Surgery Volume 93, Issue 5, Pages 1708-1710 (May 2012) DOI: 10.1016/j.athoracsur.2011.08.084 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Final fluoroscopic images after Edwards SAPIEN transcatheter valve-in-surgical mitral valve (Edwards Lifesciences LLC, Irvine, CA) implantation: (A) coaxial view; (B) lateral view, note that transcatheter valve overlaps the sewing ring of the surgical prosthesis allowing more secure fixation. The Annals of Thoracic Surgery 2012 93, 1708-1710DOI: (10.1016/j.athoracsur.2011.08.084) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Three-dimensional transesophageal echocardiography with three-dimensional zoom showing the 29-mm Edwards SAPIEN prosthesis (Edwards Lifesciences LLC, Irvine, CA) successfully placed inside the degenerated 27-mm Carpentier-Edwards bioprosthesis, “surgeon's view” en face from the left atrium during systole. The Annals of Thoracic Surgery 2012 93, 1708-1710DOI: (10.1016/j.athoracsur.2011.08.084) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions