Titre
Apical access and closure devices for transapical transcatheter heart valve procedures.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Ferrari, E.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-3997
Statut éditorial
Publié
Date de publication
2016-02
Volume
146
Première page
w14237
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article Publication Status: epublish
Résumé
The majority of transcatheter aortic valve implantations, structural heart procedures and the newly developed transcatheter mitral valve repair and replacement are traditionally performed either through a transfemoral or a transapical access site, depending on the presence of severe peripheral vascular disease or anatomic limitations. The transapical approach, which carries specific advantages related to its antegrade nature and the short distance between the introduction site and the cardiac target, is traditionally performed through a left anterolateral mini-thoracotomy and requires rib retractors, soft tissue retractors and reinforced apical sutures to secure, at first, the left ventricular apex for the introduction of the stent-valve delivery systems and then to seal the access site at the end of the procedure. However, despite the advent of low-profile apical sheaths and newly designed delivery systems, the apical approach represents a challenge for the surgeon, as it has the risk of apical tear, life-threatening apical bleeding, myocardial damage, coronary damage and infections. Last but not least, the use of large-calibre stent-valve delivery systems and devices through standard mini-thoracotomies compromises any attempt to perform transapical transcatheter structural heart procedures entirely percutaneously, as happens with the transfemoral access site, or via a thoracoscopic or a miniaturised video-assisted percutaneous technique. During the past few years, prototypes of apical access and closure devices for transapical heart valve procedures have been developed and tested to make this standardised successful procedure easier. Some of them represent an important step towards the development of truly percutaneous transcatheter transapical heart valve procedures in the clinical setting.
PID Serval
serval:BIB_9215E462CA1D
PMID
Open Access
Oui
Date de création
2016-02-29T08:01:52.335Z
Date de création dans IRIS
2025-05-21T03:43:18Z
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Nom
26900765.pdf
Version du manuscrit
published
Taille
776.87 KB
Format
Adobe PDF
PID Serval
serval:BIB_9215E462CA1D.P001
URN
urn:nbn:ch:serval-BIB_9215E462CA1D3
Somme de contrôle
(MD5):8f8a56bc4f686f123e1b773914be26a8