Clinical Experience With Percutaneous Left Ventricular Transapical Access for Interventions in Structural Heart Defects

Jelnin, Vladimir; Dudiy, Yuriy; Einhorn, Bryce; Kronzon, Itzhak; Cohen, Howard A.; Ruiz, Carlos E.

doi:10.1016/j.jcin.2011.05.018

Cited by 105 publications

(62 citation statements)

References 10 publications

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“…Following percutaneous TA puncture, use of closure devices is recommended if the sheats used are larger than 5F [12]. For smaller sheats, the access site is generally occluded by LV myocardial motion.…”

Section: Discussionmentioning

confidence: 99%

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Transapical Paravalvular Leak Closure: A Case Report

Ilkay¹,

Tari²,

Canbay³

et al. 2017

Angiol

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Section: Discussionmentioning

confidence: 99%

“…Jude Medical) as we had used a 7F sheat. Meticulous pre-procedure planning and safe exit from LV via using an occluder device enabled us to omit major complications of LV apical puncture such as laceration of coronary, pleural or intercostal vessels during access or hemothorax caused by bleeding from LV puncture site [12,13].…”

Section: Discussionmentioning

confidence: 99%

Transapical Paravalvular Leak Closure: A Case Report

Ilkay¹,

Tari²,

Canbay³

et al. 2017

Angiol

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“…Transcatheter closure of mitral PVR can be approached from a retrograde or antegrade approach. The transapical approach for mitral PVR closure has been shown to reduce procedural and fluoroscopy time 118 ; however, use of a steerable guide catheter (ie, Agilis) has made the antegrade approach highly feasible for any paramitral paravalvular defect ( Figure 3B). …”

Section: Surgical Prosthetic Valve Pvrmentioning

confidence: 99%

Transcathether Valve Replacement and Valve Repair

Hahn

2016

Circulation Research

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Transcatheter aortic valve replacement for treatment of aortic stenosis has now become an accepted alternative to surgical valve replacement for some patients. In addition, transcatheter mitral valve repair is also routinely used in high surgical risk patients with mitral regurgitation. Other transcatheter procedures are in rapid development. The current review attempts to summarize the procedures and echocardiographic imaging used for transcatheter valve replacement or valve repair.

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“…This technique is less invasive compared with open access, but is associated with a risk of coronary artery dissection that may be reduced with preprocedural computed tomography. 15,29 The advantage of open versus transcutaneous transapical access is that it provides a direct visualization of the cardiac apex and enables the use of multiple sheaths for simultaneous occluder device implantation.…”

Section: Transapical Accessmentioning

confidence: 99%

Open Transapical Approach to Transcatheter Paravalvular Leakage Closure

Nijenhuis

Swaans

Post

et al. 2014

Circ: Cardiovascular Interventions

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Background-Significant prosthetic paravalvular leakage (PVL) could have serious clinical consequences and impairs survival. Reoperation is associated with a high mortality rate, and transcatheter closure is a new treatment modality for high-risk patients. The goal of this study was to determine safety and midterm clinical efficacy of transcatheter PVL closure using an open transapical approach. Methods and Results-All consecutive patients who underwent transcatheter PVL closure in our center were prospectively enrolled. Pre-and postprocedural quality of life and 6-minute walk test were ascertained. All outcomes were defined according to the Valve Academic Research Consortium-2 consensus document. In total, 37 consecutive patients (mean age 67±12 years, 65% male, logistic European System for Cardiac Operative Risk Evaluation 27±17%, Society of Thoracic Surgeons score 7±4%) with severe symptomatic PVL in mitral (81%) or aortic (19%) position underwent transcatheter PVL closure. Procedure success was 86%. Early safety at 30 days (ie, event-free survival) was 84%. The 1-year survival rate was 66%. New York Heart Association functional class and quality of life significantly improved. Clinical efficacy (ie, survival free of stroke, rehospitalization, New York Heart Association 3/4, and device-related dysfunction) was 49% at 3 months and 31% at 1 year. Moderate to severe residual PVL was associated with all-cause mortality (hazard ratio, 3.9; 95% confidence interval, 1.2-12.1; P=0.03). Conclusions-The open transapical approach to PVL closure in high-risk patients has a high procedural success rate with an acceptable risk of adverse outcomes. This is the first study to prove an increased functional capacity and quality of life after transapical PVL closure. Residual PVL is associated with 1-year mortality. (Circ Cardiovasc Interv. 2014;7:611-620.)Key Words: heart failure ◼ heart valve diseases ◼ heart valve prosthesis ◼ mitral valve insufficiency ◼ quality of life ◼ septal occluder device ◼ surgical procedures, minimally invasive

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Clinical Experience With Percutaneous Left Ventricular Transapical Access for Interventions in Structural Heart Defects

Cited by 105 publications

References 10 publications

Transapical Paravalvular Leak Closure: A Case Report

Transapical Paravalvular Leak Closure: A Case Report

Transcathether Valve Replacement and Valve Repair

Open Transapical Approach to Transcatheter Paravalvular Leakage Closure

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