Use of a Ventricular Septal Defect Occluder for Apical Closure in Transapical Aortic Valve Replacement. (January 2015)

• Record Type: Journal Article
• Authors: Ferrari, Enrico; Locca, Didier; Berdajs, Denis; Marcucci, Carlo; Gronchi, Fabrizio; Lavanchy, Jerome; Prêtre, René; Tozzi, Piergiorgio
• Is Part Of: Innovations. Volume 10(2015:Jan.)Supplement 1
• Page Start: 68
• Page End: 70
• Publication Date: 2015-01
• Subjects: Transcatheter aortic valve replacement -- Myocardial closure devices -- Aortic stenosis; Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1097/imi.0000000000000118
• Languages: English
• ISSNs: 1556-9845

Abstract

During transapical transcatheter aortic valve replacement (TA-TAVR), the apical closure remains a challenge for the surgeon, having the risk for ventricular tear and massive bleeding. Apical closure devices are already under clinical evaluation, but only a few can lead to a full percutaneous TA-TAVR. We describe the successful use of a 9-mm myocardial occluder (ventricular septal defect occluder) that was used to seal the apex after a standard TA-TAVR (using the Sapien XT 23-mm transcatheter valve and the Ascendra + delivery system). The placement of the nonmodified myocardial occluder was performed through the Ascendra + delivery system, with a very small amount of blood loss and an acceptable sealing of the apical tear. This approach is feasible and represents a further step toward true-percutaneous transapical heart valve procedures. Modified apical occluders are under evaluation in animal models.