Objective: Transluminal resection of the aortic valve was already successfully carried out by our group. The aim of this study was the analysis of the gross anatomy and the histology of the surrounding tissue after resection.
Methods: Aortic valve resection was performed in postmortem human hearts (endoluminal (EL) n=9, transapical (TA) n=4). After deployment of the aortic valve isolation chamber, the leaflets were resected with a Thullium:YAG laser scalpel (cw, 20W). After resection, the hearts were analyzed to check for lesions caused by resectioning the associated tools. Therefore, gross anatomy and histological analysis were performed (H&E staining).
Results: Lesions of the aortic annulus were seen in 3/9 (EL) (depth: 583+/-186 microm) and 2/4 (TA) (120 microm and one complete perforation), lesions of the aorta (ascending-arch-descending) in 4-9-0/9 (EL) and 0-0-0/4 (TA), lesions of the mitral valve in 0/9 (EL) and 0/4 (TA), lesions of the papillary muscle in 0/9 (EL) and 2/4 (TA) (depth: 400 microm and 450 microm), lesions of the endomyocardium in 0/9 (EL) and 4/4 (TA) (depth: 258+/-102 microm). The coronary ostia remained unaffected.
Conclusions: This study shows fewer severe lesions in the aorta after transapical antegrade access compared to the transluminal retrograde approach. Especially noteworthy is that the aortic arch remains unaffected by the transapical procedure. These data demonstrate the transapical approach as less hazardous.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ejcts.2009.03.031 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A proposed algorithm for management of patients with left bundle branch block post-TAVR: 1-year follow-up.
Heart Rhythm O2
December 2024
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Background: Transcatheter aortic valve replacement (TAVR) has revolutionized the management of aortic stenosis and has become the standard of care across a broad spectrum of patients with aortic stenosis. However, it is still associated with high incidence of conduction abnormalities, particularly new left bundle branch block (LBBB). Management of these patients remains a challenge.
View Article and Find Full Text PDFAnomalous Right Coronary Artery: Culprit or Innocent Bystander?
Case Rep Cardiol
January 2025
Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Anomalous aortic origin of a coronary artery is a rare congenital heart defect. The detection of anomalous coronary arteries is likely to increase with increased availability and application of cardiac computed tomography and magnetic resonance imaging. Once detected, the recommendation for surgical intervention on anomalous coronary arteries depends upon patient symptoms, the presence or absence of inducible ischemia on stress imaging, and high-risk anatomic features.
View Article and Find Full Text PDFHeyde's Syndrome Manifesting as Recurrent Gastrointestinal Bleeding After Valve Replacement.
Cureus
December 2024
Internal Medicine, Hospital Universitario Dr. José Eleuterio González, Monterrey, MEX.
Heyde's syndrome is a clinical entity that combines aortic stenosis, gastrointestinal angiodysplasia, and an acquired von Willebrand factor disorder. This syndrome is characterized by the association between aortic stenosis and recurrent gastrointestinal bleeding episodes, typically linked to angiodysplasias. Effective treatment requires addressing the underlying condition, specifically aortic stenosis, which leads to the structural destruction of coagulation proteins, resulting in the acquired von Willebrand factor disorder and perpetuating the bleeding.
View Article and Find Full Text PDFAsian Pacific Society of Cardiology Position Statement on the Use of Transcatheter Aortic Valve Implantation in the Management of Aortic Stenosis.
JACC Asia
December 2024
Department of Cardiology, National Heart Centre Singapore, Singapore.
Transcatheter aortic valve implantation (TAVI) has been established as an effective treatment modality in patients with severe aortic stenosis (AS) and the uptake of TAVI is rapidly growing in the Asia-Pacific region. However, there exist a heterogeneity in the management of aortic stenosis and the use of TAVI among countries in the region. Reasons for these differences include anatomic variations, disparity in healthcare resources and infrastructure, and the lack of consensus on the optimal management of AS in the Asia-Pacific region.
View Article and Find Full Text PDFA stuck leaflet after balloon post-dilatation in transcatheter aortic valve implantation with a SAPIEN-3 ultra RESILIA valve: a case report.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Komaki City Hospital, 1-20 Joubushi, Komaki, Aichi 485-8520, Japan.
Background: Transcatheter aortic valve implantation (TAVI) is a safe and effective therapy for patients with severe aortic stenosis. A Stuck leaflet and severe intraprosthetic regurgitation after valve implantation occur rarely but can lead to sudden haemodynamic deterioration. We encountered a case of a stuck leaflet following post-dilatation with the Edwards Sapien 3 Ultra RESILIA valve.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!