Suprasternal transcatheter aortic valve replacement: Modified trocar-free technique

J Card Surg. 2022 Dec;37(12):5663-5665. doi: 10.1111/jocs.17117. Epub 2022 Nov 15.

Abstract

Background and aim of study: Transcatheter aortic valve replacement is established as the standard treatment for severe aortic stenosis. Many approaches have been described, including the suprasternal technique, an alternative for patients with unsuitable femoral arteries. We now describe a trocar-free technique for the Suprasternal approach.

Methods and results: Under endotracheal anesthesia, an incision is made above the manubrium and dissection is carried down to the innominate artery with adequate exposure for cannulation. Access site is closed with purse-string suture. The Suprasternal approach has relatively few contraindications.

Conclusion: Our trocar-free technique is a safe and easily reproducible technique for TAVRs in patients with poor femoral access.

Keywords: aorta and great vessels; cardiovascular research; valve repair/replacement.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Brachiocephalic Trunk / surgery
  • Femoral Artery / surgery
  • Humans
  • Transcatheter Aortic Valve Replacement* / methods
  • Treatment Outcome