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Transaortic transcatheter aortic valve replacement with the Sapien™ valve and the first generations of Ascendra™

Ferrari, Enrico ; Berdajs, Denis ; Tozzi, Piergiorgio ; Prêtre, René

In: European Journal of Cardio-Thoracic Surgery, 2014, vol. 45, no. 1, p. 188-190

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    Title
    • Transaortic transcatheter aortic valve replacement with the Sapien™ valve and the first generations of Ascendra™
    Author
    • Ferrari, Enrico. E-mail: enricoferrari@bluewin.ch
    • Berdajs, Denis. Cardiac surgery unit, University Hospital of Lausanne, Lausanne, Switzerland
    • Tozzi, Piergiorgio. Cardiac surgery unit, University Hospital of Lausanne, Lausanne, Switzerland
    • Prêtre, René. Cardiac surgery unit, University Hospital of Lausanne, Lausanne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Journal of Cardio-Thoracic Surgery, 2014, vol. 45, no. 1, p. 188-190. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:304590
    Summary
    Traditionally, the transcatheter aortic valve replacement is performed through a transapical, a transfemoral or a trans-subclavian approach. Recently, the transaortic approach for transcatheter aortic valve replacement through the distal part of the ascending aorta was successfully implemented in order to avoid peripheral vascular access-related complications and apical life-threatening haemorrhage. The Sapien™ stent valve has great transaortic potential because it can be loaded ‘upside down' in different generations of delivery systems. However, because of their health regulatory systems and despite the launch, in 2012, of the latest generation of the Ascendra™ delivery system, the Ascendra+™, specifically designed for transapical and transaortic valve placements, several countries are still using the first generations of Ascendra™ (Ascendra™ 1 and 2). This device was specifically designed for transapical procedures, and retrograde stent-valve positioning through the stenotic aortic valve may be very challenging and risk the integrity of the aorta. We describe the manoeuvre required in order to pass the stenotic aortic valve safely in a retrograde direction using the Sapien™ stent valve and the first generations of Ascendra™