Transapical transcatheter off-pump aortic valve implantation is a minimally invasive technique that offers a promising alternative for high-risk elderly patients.
Transapical aortic valve implantation (TA-AVI) is a new minimally invasive technique for beating-heart off-pump AVI in high-risk patients. The procedure involves antegrade AVI using an oversizing technique with direct access and accurate positioning of a stent based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral minithoracotomy, placement of an epicardial pacing wire and two apical purse-string sutures. Valve implantation is performed off-pump under fluoroscopic and echocardiographic guidance with rapid ventricular pacing. This new technology is a promising alternative for selected elderly high-risk patients and seems to be associated with good outcome and a minimal stroke risk.
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Kempfert et al. (2010) studied this question.
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