Direct-Access Valve Replacement
A Novel Approach for Off-Pump Valve Implantation Using Valved Stents
Christoph H. Huber, MD*,*,
Lawrence H. Cohn, MD* and
Ludwig K. von Segesser, MD
* Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
Service de Chirurgie Cardiovasculaire, Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland.
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Figure 1 Valved stent used for off-pump direct-access antegrade implantation.
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Figure 2 Navigating the valved stent through the heart with intracardiac ultrasound (AcuNav) and intravascular ultrasound (IVUS) guidance.
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Figure 3 Valved stent and delivery system: the off-pump valved stent was collapsed radially and then manually loaded into a standard endoprosthetic delivery device with a maximum diameter of 9.2 mm.
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Figure 4 Intracardiac ultrasound after orthotopic valved stent implantation. LCA = left coronary artery.
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Figure 5 M-mode recordings showing stable left anterior descending flow before (top) and after (bottom) valved stent implantation.
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Figure 6 A valved stent in situ after antegrade off-pump implantation at necropsy. The light blue catheter is inside the left coronary artery orifice; the dark blue catheter in the right coronary artery.
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