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J Thorac Cardiovasc Surg 2006;131:1194-1196
© 2006 The American Association for Thoracic Surgery

Brief Communication

Transapical aortic valve implantation in humans

Jian Ye, MD, Anson Cheung, MD, Samuel V. Lichtenstein, MD, PhD * , Ronald G. Carere, MD, Christopher R. Thompson, MD, Sanjeewan Pasupati, MD, John G. Webb, MD

Divisions of Cardiac Surgery and Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada

Received for publication November 28, 2005; revisions received January 4, 2006; accepted for publication January 12, 2006.

* Address for reprints: Samuel V. Lichtenstein, MD, PhD, Head, Cardiac Surgery, University of British Columbia, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6 (Email: slichtenstein@providencehealth.bc.ca).

The first 20% of the full text of this article appears below.


Dr John Webb is a consultant at Edwards Lifesciences, Irvine, Calif.


GoCalcific aortic stenosis is the most common valvular disease affecting the elderly. Surgical aortic valve replacement improves symptoms and prognosis, but mortalities may be as high as 20% in elderly patients with left ventricular dysfunction. 1 Go Catheter-based aortic valve implantation was recently achieved through antegrade venous 2 Go and retrograde arterial routes. 3 Go We report on the deployment of an aortic valve prosthesis for severe aortic stenosis through the apex of the left ventricle in a 75-year-old patient without cardiopulmonary bypass or sternotomy.

Methods

Case Report
The procedure was approved by the Therapeutic Products Directorate, Department of Health and Welfare, Ottawa, Canada, for compassionate clinical use in patients deemed not to be candidates for surgery and without arterial access.

An emaciated, 52-kg, 75-year-old woman presented in congestive heart failure. Comorbidities included restrictive lung disease, severe psoriatic arthropathy, a calcified thoracic aorta, a large infrarenal aortic aneurysm, and bilateral aortoiliac disease. Cardiac catheterization revealed pulmonary hypertension and severe aortic stenosis with a mean gradient of 54 mm Hg and 0.4 cm2 valve area. Echocardiograms demonstrated a mean gradient of 31 to 48 mm Hg, . . . [Full Text of this Article]


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J. Thorac. Cardiovasc. Surg. 2006 131: 941-943. [Extract] [Full Text] [PDF]



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