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Transapical Transcatheter Aortic Valve Implantation

Published byHans-Petter Andresen Modified over 5 years ago

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Presentation on theme: "Transapical Transcatheter Aortic Valve Implantation"— Presentation transcript:

1 Transapical Transcatheter Aortic Valve Implantation
Yanai Ben-Gal, MD, Mathew Williams, MD  Operative Techniques in Thoracic and Cardiovascular Surgery  Volume 16, Issue 1, Pages (March 2011) DOI: /j.optechstcvs Copyright © 2011 Elsevier Inc. Terms and Conditions

2 Figure 1 Hybrid OR setup for TA-AVI. TEE = transesophageal echocardiograph. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

3 Figure 2 Patient positioning.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

4 Figure 3 Patient draping and positioning.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

5 Figure 4 (A, B) Fluoroscopic estimation of cardiac apex location. (C) Aortic “root shot” for appropriate deployment view. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

6 Figure 5 Left anterior thoracotomy.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

7 Figure 6 Soft tissue retractor and pericardial traction stitches.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

8 Figure 7 It is possible to add a small rigid retractor.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

9 Figure 8 Purse-string position on cardiac apex. LAD = left anterior descending coronary artery. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

10 Figure 9 Deep needle bites required.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

11 Figure 10 (A) Purse-string configuration on cardiac apex. (B) Ascendra balloon valvuloplasty catheter. (C) Ascendra valve deployment catheter. (Color version of figure is available online at Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

12 Figure 11 Correct valve orientation for TA-AVI.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

13 Figure 12 Needle and wire introduction.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

14 Figure 13 Wire advancement.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

15 Figure 14 Introducer sheath advancement. (Color version of figure is available online at Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

16 Figure 15 Valvuloplasty balloon positioning. (A) White arrow demarcates calcified aortic valve. (B) Valvuloplasty. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

17 Figure 16 Hemodynamic tracing during valvuloplasty and also during valve deployment. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

18 Figure 17 Valve loader. Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

19 Figure 18 Loading the valve into introducer sheath.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

20 Figure 19 Valve positioning.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

21 Figure 20 Fine positioning (after pusher rod retrieved into introducer). Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

22 Figure 21 Valve deployment in stages.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

23 Figure 22 Final aortography.
Operative Techniques in Thoracic and Cardiovascular Surgery  , 41-61DOI: ( /j.optechstcvs ) Copyright © 2011 Elsevier Inc. Terms and Conditions

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