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The trans-subclavian retrograde approach for transcatheter aortic valve replacement: Single-center experience  Giuseppe Bruschi, MD, Pasquale Fratto,

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Presentation on theme: "The trans-subclavian retrograde approach for transcatheter aortic valve replacement: Single-center experience  Giuseppe Bruschi, MD, Pasquale Fratto,"— Presentation transcript:

1 The trans-subclavian retrograde approach for transcatheter aortic valve replacement: Single-center experience  Giuseppe Bruschi, MD, Pasquale Fratto, MD, Federico De Marco, MD, Jacopo Oreglia, MD, Paola Colombo, MD, PhD, Luca Botta, MD, Aldo Cannata, MD, Antonella Moreo, MD, Benedetta De Chiara, MD, Francesca Lullo, MD, Roberto Paino, MD, Luigi Martinelli, MD, Silvio Klugmann, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 140, Issue 4, Pages e2 (October 2010) DOI: /j.jtcvs Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 After subclavian exposure, the 18F introducer is inserted over an Amplatz (Amplatz Cook, Inc, Bloomington, Ind) super stiff guidewire. The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 CoreValve (Medtronic CV Luxembourg S.a.r.l.) delivery catheter and prosthesis are advanced in place. Notice the short distance from the subclavian access to the aortic annulus requiring weaker forces of tension and torsion. The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Immediately after CoreValve deployment, ascending aorta angiography was performed to assess the correct positioning of the device, periprosthesis regurgitation, and patency of the coronary arteries. The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

5 Supra -aortic vessel angiography to assess left subclavian artery size, course, and calcification.
The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

6 Subclavian exposure after incision of cutaneous and subcutaneous tissue.
The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

7 The CoreValve revalving system 18F introducer was carefully advanced to the ascending aorta.
The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

8 After careful checking of the CoreValve's position, the valve was released.
The Journal of Thoracic and Cardiovascular Surgery  , e2DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

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