Top

CardioVascular and Interventional Radiology

Published in:

01-08-2018 | Technical Note

Branched Thoraco-Abdominal Aortic Aneurysm Repair with Branch Access Through a Transapical Left Ventricular Approach

Authors: Amir Helmy, Pedro Catarino, John Dunning, Paul Hayes, Serena Goon, Andrew Winterbottom

Published in: CardioVascular and Interventional Radiology | Issue 8/2018

Abstract

Branched thoracic aortic aneurysm repair requires arterial access from above the diaphragm in order to insert the visceral branches. This is routinely performed from the subclavian, axillary or carotid arteries and less commonly direct thoracic aorta puncture. The left ventricular apex is an alternative access route which is commonly used for percutaneous aortic valve replacement and rarely used for EVAR, FEVAR and TEVAR access. Here we describe two patients for which the left ventricular apex was the most suitable available access to the visceral branches during a branched thoracic aortic aneurysm repair. This access should be considered as an alternative approach if conventional arterial access is not available.

Minion DJ, Davenport DL. Access techniques for EVAR: percutaneous techniques and working with small arteries. Semin Vasc Surg. 2012;25(4):208–16.CrossRefPubMed

Saadi EK, Dussin LH, Moura L, Machado AS. The axillary artery–a new approach for endovascular treatment of thoracic aortic diseases. Interact Cardiovasc Thorac Surg. 2010;11(5):617–9.CrossRefPubMed

Mylotte D, Sudre A, Teiger E, Obadia JF, Lee M, Spence M, et al. Transcarotid transcatheter aortic valve replacement: feasibility and safety. JACC Cardiovasc Interv. 2016;9(5):472–80.CrossRefPubMed

Botta L, Bruschi G, Fratto P, Margari V, Solcia M, Borgia F, et al. Direct transaortic TEVAR: an alternative option for selected patients with unsuitable peripheral access. Ann Thorac Surg. 2016;102(2):e117–9.CrossRefPubMed

Komlo CM, Vallabhajosyula P, Bavaria JE, Desai ND, Anwaruddin S, Giri JS, et al. Combined transaortic transcatheter valve replacement and thoracic endografting. Ann Thorac Surg. 2014;97(2):696–8.CrossRefPubMed

Ferrari E, Marcucci C, Sulzer C, Rizzo E, von Segesser LK. No arterial access: a ‘blind flight’ for a transapical aortic valve implantation (TAVI). J Heart Valve Dis. 2010;19(2):266–8.PubMed

MacDonald S, Cheung A, Sidhu R, Rheaume P, Grenon SM, Clement J. Endovascular aortic aneurysm repair via the left ventricular apex of a beating heart. J Vasc Surg. 2009;49(3):759–62.CrossRefPubMed

Saouti N, Vos JA, van de Heuvel D, Morshuis WJ, Heijmen RH. Thoracic aorta stent grafting through transapical access. Ann Vasc Surg. 2015;29(2):362e5-9.CrossRef

Ramponi F, Vallely MP, Stephen MS, Bannon PG, Bayfield MS, White GH. Transapical wire-assisted endovascular repair of thoracic aortic dissection. J Endovasc Ther. 2011;18(3):350–4.CrossRefPubMed

10.

Mahnken AH, Irqsusi M, Hundt W, Moosdorf RG. Initial experience with the transapical access for TEVAR. Rofo. 2017;189(8):760–4.CrossRefPubMed

11.

Dias-Neto M, Reis PV, Rolim D, Ramos JF, Teixeira JF, Sampaio S. Strategies to prevent TEVAR-related spinal cord ischemia. Vascular. 2017;25(3):307–15.CrossRefPubMed

12.

Ghazy TG, Ouda AS, Mashhour AM, Wilbring M, Matschke K, Kappert UW. Transapical aortic stenting: an initial case series. EuroIntervention. 2016;12(10):1305–10.CrossRefPubMed

13.

Ahn SH, Prince EA, Dubel GJ. Basic neuroangiography: review of technique and perioperative patient care. Semin Intervent Radiol. 2013;30(3):225–33.CrossRefPubMedPubMedCentral

14.

Koifman E, Magalhaes M, Kiramijyan S, Escarcega RO, Didier R, Torguson R, et al. Impact of transfemoral versus transapical access on mortality among patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Cardiovasc Revasc Med. 2016;17(5):318–21.CrossRefPubMed

15.

Bleiziffer S, Piazza N, Mazzitelli D, Opitz A, Bauernschmitt R, Lange R. Apical-access-related complications associated with trans-catheter aortic valve implantation. Eur J Cardiothorac Surg. 2011;40(2):469–74.PubMed

16.

Karck M, Chavan A, Hagl C, Friedrich H, Galanski M, Haverich A. The frozen elephant trunk technique: a new treatment for thoracic aortic aneurysms. J Thorac Cardiovasc Surg. 2003;125(6):1550–3.CrossRefPubMed

Title: Branched Thoraco-Abdominal Aortic Aneurysm Repair with Branch Access Through a Transapical Left Ventricular Approach
Authors: Amir Helmy
Pedro Catarino
John Dunning
Paul Hayes
Serena Goon
Andrew Winterbottom
Publication date: 01-08-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 8/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-018-1973-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Branched Thoraco-Abdominal Aortic Aneurysm Repair with Branch Access Through a Transapical Left Ventricular Approach

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2018

Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration

Prostatic Fragment Requiring Endoscopic Management After Prostatic Artery Embolization for Indwelling Bladder Catheter

Radioembolization for Hepatocellular Carcinoma Arising in the Setting of a Congenital Extrahepatic Portosystemic Shunt (Abernethy Malformation)

CT-Guided Percutaneous Trans-scapular Lung Biopsy in the Diagnosis of Peripheral Pulmonary Lesion Nodules of the Superior Lobes Using Large Needles

Image Fusion Guidance with Pre-procedural CT with Real-Time Fluoroscopy for Adrenal Venous Sampling

Combined Static and Dynamic Computed Tomography Angiography of Peripheral Artery Occlusive Disease: Comparison with Magnetic Resonance Angiography