TAVI for Pure Aortic Valve Insufficiency in a Patient With a Left Ventricular Assist Device Giuseppe D'Ancona, MD, PhD, Miralem Pasic, MD, PhD, Semih.

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Presentation transcript:

TAVI for Pure Aortic Valve Insufficiency in a Patient With a Left Ventricular Assist Device Giuseppe D'Ancona, MD, PhD, Miralem Pasic, MD, PhD, Semih Buz, MD, Thorsten Drews, MD, Stephan Dreysse, MD, Roland Hetzer, MD, PhD, Axel Unbehaun, MD The Annals of Thoracic Surgery Volume 93, Issue 4, Pages e89-e91 (April 2012) DOI: 10.1016/j.athoracsur.2011.11.019 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Echocardiogram shows aortic valve insufficiency jet (white arrow heads) and native aortic valve without calcification (white arrow). The Annals of Thoracic Surgery 2012 93, e89-e91DOI: (10.1016/j.athoracsur.2011.11.019) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Cardiac computed tomographic scan demonstrating no calcification in the aortic valve (black asterisk). The Annals of Thoracic Surgery 2012 93, e89-e91DOI: (10.1016/j.athoracsur.2011.11.019) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Preoperative computed tomographic scan showing the chosen direct surgical access (white arrow) to puncture the left ventricular apex in the anterior aspect, avoiding the ventricular assist device (black asterisk). The Annals of Thoracic Surgery 2012 93, e89-e91DOI: (10.1016/j.athoracsur.2011.11.019) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Sequences of transcatheter aortic valve implantation. The valve (black arrow) is released slowly and during simultaneous contrast injection (white arrow). (A) Angiography immediately before starting balloon inflation; (B) initial balloon inflation for valve deployment; (C) almost complete balloon inflation with angiography to verify valve position; (D) complete balloon inflation and valve deployment. The Annals of Thoracic Surgery 2012 93, e89-e91DOI: (10.1016/j.athoracsur.2011.11.019) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Postoperative chest roentgenogram showing stable valve position and anchoring (white arrow). Note the left ventricular assist device in the left ventricular apex (black asterisk) and the outflow cannula of the device in the thoracic descending aorta (black arrow). The Annals of Thoracic Surgery 2012 93, e89-e91DOI: (10.1016/j.athoracsur.2011.11.019) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions