Feasibility of transapical aortic valve implantation guided by intracardiac ultrasound without angiography Enrico Ferrari, MD, Carlo Marcucci, MD, Stefano.

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Feasibility of transapical aortic valve implantation guided by intracardiac ultrasound without angiography Enrico Ferrari, MD, Carlo Marcucci, MD, Stefano Di Bernardo, MD, Ludwig Karl von Segesser, MD The Journal of Thoracic and Cardiovascular Surgery Volume 140, Issue 2, Pages e32-e34 (August 2010) DOI: 10.1016/j.jtcvs.2010.01.007 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Image taken from the fluoroscopic machine shows the ICE probe in the superior vena cava (black arrow), a pigtail catheter in the ascending aorta against the valve leaflets, and a super-stiff guidewire through the cardiac apex and the aortic valve. B, Image taken from the fluoroscopic machine shows the ICE probe (black arrow) placed into the right atrium during stent-valve deployment. The Journal of Thoracic and Cardiovascular Surgery 2010 140, e32-e34DOI: (10.1016/j.jtcvs.2010.01.007) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Images taken from the ICE inserted through the left subclavian vein. A, Edwards-Sapien stent-valve positioning (Edwards Lifesciences, Irvine, Calif). The ventricular and aortic edges of the crimped stent valve (thin and thick arrows, respectively) are identified, and the valve is positioned in the ideal landing zone. B and C, Postoperative control showing the correct opening and closure of the device during systole and diastole. The Journal of Thoracic and Cardiovascular Surgery 2010 140, e32-e34DOI: (10.1016/j.jtcvs.2010.01.007) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions