Saouti Nabil, Vos Jan Albert, van de Heuvel Daniel, Morshuis William J, Heijmen Robin H
Department of Cardio-Thoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
Department of Radiology, Interventional Radiology, St Antonius Hospital, Nieuwegein, The Netherlands.
Ann Vasc Surg. 2015 Feb;29(2):362.e5-9. doi: 10.1016/j.avsg.2014.09.018. Epub 2014 Nov 13.
To describe the transapical approach for thoracic endovascular aortic repair (TEVAR).
Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The technique is described in detail emphasizing the usefulness of the through-and-through guidewire, rapid pacing, and transesophageal echocardiography guidance.
All patients were technical successfully treated with TEVAR through transapical access. The emergent patient, however, died due to multiorgan failure.
Our early experience shows that the transapical approach for TEVAR procedures is feasible in experienced hands. The selection of the patient and careful planning based on imaging are of paramount importance and should lead to the most suitable access site tailored to the need of the individual patient.
描述经心尖途径行胸主动脉腔内修复术（TEVAR）。
描述了3例患者，2例择期手术，1例急诊手术，均为胸主动脉瘤患者，因血管入路或直接主动脉入路不可行，通过经心尖入路接受TEVAR治疗。详细描述了该技术，强调了贯穿导丝、快速起搏和经食管超声心动图引导的作用。
所有患者均通过经心尖入路成功接受TEVAR技术治疗。然而，急诊患者因多器官功能衰竭死亡。
我们的早期经验表明，经心尖途径行TEVAR手术在经验丰富的术者手中是可行的。患者的选择以及基于影像学的仔细规划至关重要，应根据个体患者的需求选择最合适的入路部位。
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