Conflict of interest: Dr. Bapat, Dr. Young, Dr. Thomas and Dr. Redwood are Proctors for Edwards Lifescisnces for the TAVI procedure.
Valvular and Structural Heart Diseases
Transaortic transcatheter aortic valve implantation using edwards sapien valve†
A Novel Approach
Article first published online: 26 SEP 2011
Copyright © 2011 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 79, Issue 5, pages 733–740, 1 April 2012
How to Cite
Bapat, V., Khawaja, M. Z., Attia, R., Narayana, A., Wilson, K., Macgillivray, K., Young, C., Hancock, J., Redwood, S. and Thomas, M. (2012), Transaortic transcatheter aortic valve implantation using edwards sapien valve. Cathet. Cardiovasc. Intervent., 79: 733–740. doi: 10.1002/ccd.23276
- Issue published online: 27 MAR 2012
- Article first published online: 26 SEP 2011
- Accepted manuscript online: 29 JUL 2011 11:16AM EST
- Manuscript Accepted: 11 JUN 2011
- Manuscript Received: 19 MAY 2011
- aortic stenosis;
- minimally invasive;
- mini sternotomy
Objectives: To evaluate feasibility and outcome of Transoartic Transcatheter Sapien valve implantation. Background: Transcatheter Aortic valve implantation (TAVI) using the Edwards SAPIEN device (Edwards LifeScience, Irvine, CA) is usually performed via the transfemoral (TF) or transapical (TA) routes. Some patients are not suitable for these approaches. We report our experience with the novel transaortic (TAo) approach via a partial upper sternotomy and discuss the advantages and future applications. Methods: Between January 2008 to March 2011 193 patients with severe aortic stenosis underwent TAVI with the Edwards SAPIEN bioprosthesis at the St. Thomas' Hospital, London. 108 patients were unable to undergo a TF-TAVI and of those 17 were accepted for a TAo-TAVI on the basis of anatomy, risk, LV function, and significant respiratory disease. Results: The TAo-TAVI group (n = 17) had more prevalent respiratory disease than the TA-TAVI group (47.0% vs. 18.7%, P = 0.011). Otherwise the groups were similar in demographics and history. Despite this the 30 day mortalities were not significantly different between the groups (TAo-TAVI 4.3% at 30 days versus TA-TAVI 7.7%, P = 0.670). There were no significant differences in procedural complications. Conclusions: The TA-TAVI approach may not be desirable in patients with severe chest deformity, poor lung function or poor left ventricular function. TAo-TAVI via a partial sternotomy is safe and feasible in these patients. © 2011 Wiley Periodicals, Inc.