Bruschi Giuseppe, Botta Luca, De Marco Federico, Colombo Paola, Nonini Sandra, Klugmann Silvio, Martinelli Luigi
'A. De Gasperis' Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Milan, Italy.
Multimed Man Cardiothorac Surg. 2013;2013:mmt015. doi: 10.1093/mmcts/mmt015.
Transcatheter aortic valve implantation using the Medtronic CoreValve is a well-established procedure. Although previously carried out only through the common femoral artery, today it is possible to perform the procedure through different arterial alternative access sites. A direct aortic approach through the ascending aorta could be carried out via a right anterior mini-thoracotomy in the second intercostal space. The pericardium is opened to expose the aorta. Two purse-string sutures are then placed on the ascending aorta and a standard retrograde CoreValve implantation is performed with the standard delivery system. Advantages, contraindications, surgical technique and results are discussed.
使用美敦力CoreValve进行经导管主动脉瓣植入术是一种成熟的手术。尽管此前仅通过股总动脉进行，但如今通过不同的动脉替代入路部位来实施该手术已成为可能。经升主动脉的直接主动脉入路可通过第二肋间间隙的右前小切口进行。打开心包以暴露主动脉。然后在升主动脉上放置两根荷包缝线，并使用标准输送系统进行标准的逆行CoreValve植入。文中讨论了其优点、禁忌症、手术技术及结果。
