Transcatheter Aortic Valve Replacement via Left Anterior Thoracotomy in a Patient With Severe Pectus Excavatum Dan Loberman, MD, Taufiek Konrad Rajab,

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Transcatheter Aortic Valve Replacement via Left Anterior Thoracotomy in a Patient With Severe Pectus Excavatum Dan Loberman, MD, Taufiek Konrad Rajab, MD, Maroun Yammine, MD, Frederick G. Welt, MD, Andrew C. Eisenhauer, MD, Michael J. Davidson, MD The Annals of Thoracic Surgery Volume 101, Issue 1, Pages 344-346 (January 2016) DOI: 10.1016/j.athoracsur.2015.03.081 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Computed tomography image shows severe pectus excavatum and the location of the heart and great vessels entirely to the left of the midline. The Annals of Thoracic Surgery 2016 101, 344-346DOI: (10.1016/j.athoracsur.2015.03.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 A minithoracotomy over the second intercostal space was used to expose the distal ascending aorta. The Ascendra sheath (Edwards Lifesciences Corp, Irvine, CA) is seen passing retrograde over a wire. The Annals of Thoracic Surgery 2016 101, 344-346DOI: (10.1016/j.athoracsur.2015.03.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Fluoroscopic image of the new valve deploying with balloon inflation. The Ascendra sheath (Edwards Lifesciences Corp, Irvine, CA) is seen in the aorta. The Annals of Thoracic Surgery 2016 101, 344-346DOI: (10.1016/j.athoracsur.2015.03.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Postdeployment image shows the Edwards SAPIEN (Edwards Lifesciences Corp, Irvine, CA) valve is in adequate position. The Annals of Thoracic Surgery 2016 101, 344-346DOI: (10.1016/j.athoracsur.2015.03.081) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions