Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objectives: Surgical aortic valve replacement (SAVR) after transcatheter aortic valve replacement (TAVR) has a higher mortality rate than standard SAVR. We present a successful minimally invasive TAVR explantation and SAVR using the lasso technique in conjunction with a 3D endoscope.
Key Steps: 1) Aortotomy was performed where the nitinol frame was easily palpable. 2) The first purse-string suture was placed around the edge of the frame. 3) After exposing the widest part of the frame, a second purse-string suture was placed at the same level. 4) The second lasso was used to expose the annulus, ensuring safe explantation.
Potential Pitfalls: Comprehensive understanding of the prosthesis structure and the surgical dissection plane is essential to prevent aortic injury. Excessive traction can damage the annulus or aortic root.
Take-home Messages: Understanding the TAVR prosthesis and surgical plane simplified the explantation process. The lasso technique with a 3D endoscope facilitated explantation, even in high-risk patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jaccas.2025.104432 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
TAVR Patients With Nickel Allergy.
JACC Case Rep
September 2025
Lee Health Heart Institute, Fort Myers, Florida, USA. Electronic address:
Transcatheter aortic valve replacement (TAVR) is a preferred treatment option for many patients with severe aortic stenosis, but concerns exist regarding safety in patients with nickel allergy due to metallic valve frames. We report a series of 7 patients with a history of nickel allergy who underwent TAVR. Preprocedural allergy evaluation varied, including patch testing or direct skin contact with valve fragments.
View Article and Find Full Text PDFDecision-making in valve reintervention: Redo-Transcatheter aortic valve replacement vs. explant surgery.
Cardiovasc Revasc Med
August 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address:
Objective: Data remain limited on factors influencing the selection of redo-transcatheter aortic valve replacement (TAVR) versus surgical explant in patients with failing transcatheter heart valves. This study aimed to identify clinical and procedural factors guiding treatment decisions.
Methods: This single-center, retrospective study included all patients who underwent aortic valve reintervention following prior TAVR at a U.
Totally Endoscopic Approach for TAVR Explantation and Subsequent Surgical AVR Using a 3D Endoscope System.
JACC Case Rep
July 2025
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:
Objectives: Surgical aortic valve replacement (SAVR) after transcatheter aortic valve replacement (TAVR) has a higher mortality rate than standard SAVR. We present a successful minimally invasive TAVR explantation and SAVR using the lasso technique in conjunction with a 3D endoscope.
Key Steps: 1) Aortotomy was performed where the nitinol frame was easily palpable.
Robotic-Assisted Transcatheter Aortic Valve Explantation and Aortic Valve Replacement.
Ann Thorac Surg
July 2025
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.
Purpose: Transcatheter aortic valve replacement (TAVR) in younger patients may be complicated by premature structural valve degeneration. This report describes robotic TAVR explantation and aortic valve replacement.
Description: A 67-year-old woman who underwent low-risk, 23-mm balloon-expandable TAVR 4 years previously presented with severe prosthetic aortic stenosis, a drop in ejection fraction to 35%, severe type III mitral regurgitation, and symptomatic heart failure.
Surgical vs. Medical Management of Infective Endocarditis Following TAVR: A Systematic Review and Meta-Analysis.
J Cardiovasc Dev Dis
July 2025
Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA 19096, USA.
Background: Infective endocarditis after transcatheter aortic valve replacement (TAVR-IE) is a rare but severe complication associated with high morbidity and mortality. The optimal treatment strategy-surgical explantation versus medical therapy-remains uncertain, particularly given the technical demands of TAVR removal and the advanced age of many affected patients.
Methods: We conducted a systematic review and meta-analysis of studies comparing the surgical and medical management of TAVR-IE.