Agostinelli Andrea, Gallingani Alan, Maestri Francesco, Grossi Silvia, Gripshi Florida, De Donno Luca, Nicolini Francesco
Cardiac Surgery Division, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
Cardiac Surgery Intensive Care Unit, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
J Clin Med. 2021 Aug 27;10(17):3857. doi: 10.3390/jcm10173857.
Since the advent of TAVR (transcatheter aortic valve replacement), the transapical surgical approach has been affirmed as a safe and effective alternative access for patients with unsuitable peripheral arteries. With the improvement of devices for transfemoral approach and the development of other alternative accesses, the number of transapical procedures has decreased significantly worldwide. The left ventricular apex, however, has proved to be a safe and valid alternative access for various other structural heart procedures such as mitral valve repair, mitral valve-in-valve or valve-in-ring replacement, transcatheter mitral valve replacement (TMVR), transcatheter mitral paravalvular leak repair, and thoracic aorta endovascular repair (TEVAR). We review the literature and our experience of various hybrid transcatheter structural heart procedures using the transapical surgical approach and discuss pros and cons.
自经导管主动脉瓣置换术（TAVR）问世以来，经心尖手术入路已被确认为外周动脉不适合的患者的一种安全有效的替代入路。随着经股动脉入路器械的改进以及其他替代入路的发展，全球范围内经心尖手术的数量已显著减少。然而，左心室心尖已被证明是二尖瓣修复、二尖瓣内瓣或瓣中瓣置换、经导管二尖瓣置换术（TMVR）、经导管二尖瓣瓣周漏修复以及胸主动脉腔内修复术（TEVAR）等各种其他结构性心脏病手术的安全有效的替代入路。我们回顾了使用经心尖手术入路进行各种杂交经导管结构性心脏病手术的文献及我们的经验，并讨论其优缺点。
