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Surgical feasibility of ascending aorta manipulation after transcatheter aortic valve implantation: a computed tomography theoretical analysis

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  3. Spontaneous thrombosis of a transcatheter aortic valve replacement-induced aortic root pseudoaneurysm

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  4. Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest

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  • Igor Belluschi
  • Nicola Buzzatti
  • Vittorio Romano
  • Ole De Backer
  • Lars Søndergaard
  • Julia Karady
  • Pal Maurovich-Horvat
  • Kusha Rahgozar
  • Michele De Bonis
  • Alessandro Castiglioni
  • Antonio Colombo
  • Ottavio Alfieri
  • Matteo Montorfano
  • Azeem Latib
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AIMS: The expansion of TAVI will involve an increase in the frequency of emergent or late cardiac surgery after THV implantation. This study was designed to investigate the anatomical feasibility of surgical cross-clamp and aortotomy after TAVI through a post-TAVI CT-scan assessment.

METHODS AND RESULTS: We retrospectively analysed 117 CTs acquired after TAVI procedures with high stent prostheses in three high-volume centres between October 2008 and May 2017. The mean distance observed between the innominate artery and the top of the transcatheter heart valve was 45±11 mm, being <30 mm in 8/117 (6.8%) patients and <20 mm in none. The mean distance between the sinotubular junction and the first free site for aortotomy was 22±7 mm (>20 mm in 78/117 [66.7%] cases). A total of 56/117 (47.9%) patients showed a complete continuous contact between the anterior aortic wall and the anterior part of the valve stent.

CONCLUSIONS: Aortic cross-clamp appears not to be an issue when cardiac surgery is needed after TAVI; however, a careful and possibly higher aortotomy may be required. CT should be performed prior to planned cardiac surgery after TAVI to determine a safe positioning for aortic cross-clamp and aortotomy. Visual summary. Proper aortic cross-clamp and careful higher aortotomy after TAVI.

Original languageEnglish
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume16
Issue number18
Pages (from-to)e1533-e1540
ISSN1774-024X
DOIs
Publication statusPublished - 2 Apr 2021

ID: 62242078