Transcatheter aortic valve implantation has been designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is generally performed retrogradely with vascular access. However, in certain patients, this access is either not possible or deemed to carry a high risk of vascular injury. We report our experience of a direct aortic approach in a 78-year old man with severe aortic stenosis, excluded from standard aortic valve replacement due to a porcelain aorta, and affected by severe aortic, iliac-femoral, and subclavian arteriopathy, rendering the transfemoral or subclavian approach unemployable.
BruschiGBottaLDe MarcoF. Direct aortic access for transcatheter self-expanding aortic bioprosthetic valves implantation. Ann Thorac Surg2012; 94: 497–503.
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MoatNELudmanPde BelderMA. Long-term outcomes after transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis: the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry. J Am Coll Cardiol2011; 58: 2130–2138.
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ElhenawyARochaRFeindelCMBristerSJ. Persistent left ventricular false aneurysm after transapical insertion of an aortic valve. J Card Surg2011; 26: 51–53.
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BauernschmittRSchreiberCBleizifferS. Transcatheter aortic valve implantation through the ascending aorta: an alternative option for no-access patients. Heart Surg Forum2009; 12: E63–E64.
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BruschiGDe MarcoFFrattoP. Direct aortic access through right minithoracotomy for implantation of self-expanding aortic bioprosthetic valves. J Thorac Cardiovasc Surg2010; 140: 715–717.
