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Michael J Mack – One of the best experts on this subject based on the ideXlab platform.

  • transapical aortic valve Implantation step by step
    The Annals of Thoracic Surgery, 2009
    Co-Authors: Thomas Walther, Todd M Dewey, Michael A Borger, Jorg Kempfert, Axel Linke, Reinhardt Becht, Volkmar Falk, Gerhard Schuler, Friedrich W Mohr, Michael J Mack
    Abstract:

    Purpose Transapical aortic valve Implantation is a new minimally invasive technique for beating heart, off-pump, aortic valve Implantation in high-risk patients. Description The procedure involves antegrade aortic valve Implantation using an oversizing technique with direct access and accurate positioning of a stent-based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral mini-thoracotomy, epicardial pacing, and apical pursestring suture placement. Valve positioning is performed under fluoroscopic and echocardiographic guidance during rapid ventricular pacing. Evaluation Patient screening, especially regarding native aortic annulus diameter and pattern of calcification, is essential for success. Since imaging is crucial, Implantations are optimally performed in a hybrid operative theater by an experienced team of cardiac surgeons, cardiologists, and anesthetists. Conclusions The aim of this article is to outline the technical aspects of the new technique of minimally invasive transapical aortic valve Implantation.

Ronald G Carere – One of the best experts on this subject based on the ideXlab platform.

  • transcatheter valve in valve Implantation for failed bioprosthetic heart valves
    Circulation, 2010
    Co-Authors: John G Webb, David A Wood, Ronen Gurvitch, Jeanbernard Masson, Josep Rodescabau, Mark Osten, Eric Horlick, Olaf Wendler, Eric Dumont, Ronald G Carere
    Abstract:

    Background— The majority of prosthetic heart valves currently implanted are tissue valves that can be expected to degenerate with time and eventually fail. Repeat cardiac surgery to replace these valves is associated with significant morbidity and mortality. Transcatheter heart valve Implantation within a failed bioprosthesis, a “valve-in-valve” procedure, may offer a less invasive alternative. Methods and Results— Valve-in-valve Implantations were performed in 24 high-risk patients. Failed valves were aortic (n=10), mitral (n=7), pulmonary (n=6), or tricuspid (n=1) bioprostheses. Implantation was successful with immediate restoration of satisfactory valve function in all but 1 patient. No patient had more than mild regurgitation after Implantation. No patients died during the procedure. Thirty-day mortality was 4.2%. Mortality was related primarily to learning-curve issues early in this high-risk experience. At baseline, 88% of patients were in New York Heart Association functional class III or IV; at th…

Rudiger Lange – One of the best experts on this subject based on the ideXlab platform.

  • predictors for new onset complete heart block after transcatheter aortic valve Implantation
    Jacc-cardiovascular Interventions, 2010
    Co-Authors: Sabine Bleiziffer, Hendrik Ruge, Jurgen Horer, A Hutter, Sarah Geisbusch, Gernot Brockmann, Domenico Mazzitelli, Robert Bauernschmitt, Rudiger Lange
    Abstract:

    Objectives The aim of this study was to identify risk factors for new-onset atrioventricular (AV) block requiring pacemaker (PM) Implantation after transcatheter aortic valve Implantation (TAVI). Background High-grade AV block and consecutive PM Implantation are frequent complications following TAVI. Methods For logistic regression analysis, we included 159 patients (mean age: 81 ± 6 years, EuroSCORE: 22 ± 13%) who underwent TAVI (n = 116 transfemoral, n = 4 via subclavian arteartery, n = 37 transapical, n = 2 transaortic) between June 2007 and January 2009 and who had no previously implanted PM. Results Thirty-five patients (22%) developed new-onset post-operative AV block with the need of PM Implantation. Logistic regression revealed a 2-fold increased risk for new-onset AV block in patients in whom a large valve is implanted in a small annulus (32% pacemaker Implantations, odds ratio [OR]: 2.378, p = NS), a 4-fold increased risk with the Implantation of the CoreValve (Medtronic, Minneapolis, Minnesota) versus the Edwards Sapien valve (Edwards Lifesciences, Irvine, California) (27% pacemaker Implantations, OR: 3.781, p = NS), and a 5-fold increased risk for patients who exhibit an AV block episode instantly during the Implantation procedure (49% pacemaker Implantations, OR: 4.819, p = 0.001). Pre-existing ECG alterations were not identified as risk factors for AV block after transcatheter aortic valve Implantation. Conclusions We assume that conduction tissue impairment is provoked by mechanical compression with large prostheses in smaller annuli or in the larger area of the CoreValve covering the outflow tract and may appear instantly during the Implantation procedure. Continuous post-operative electrocardiogram monitoring should be performed for at least 3 days in all patients after TAVI procedures and until discharge in patients with increased risk for this complication.

Sven Martens – One of the best experts on this subject based on the ideXlab platform.

Thomas Walther – One of the best experts on this subject based on the ideXlab platform.

  • transapical aortic valve Implantation step by step
    The Annals of Thoracic Surgery, 2009
    Co-Authors: Thomas Walther, Todd M Dewey, Michael A Borger, Jorg Kempfert, Axel Linke, Reinhardt Becht, Volkmar Falk, Gerhard Schuler, Friedrich W Mohr, Michael J Mack
    Abstract:

    Purpose Transapical aortic valve Implantation is a new minimally invasive technique for beating heart, off-pump, aortic valve Implantation in high-risk patients. Description The procedure involves antegrade aortic valve Implantation using an oversizing technique with direct access and accurate positioning of a stent-based transcatheter xenograft. Procedural steps include placement of femoral arterial and venous access wires, anterolateral mini-thoracotomy, epicardial pacing, and apical pursestring suture placement. Valve positioning is performed under fluoroscopic and echocardiographic guidance during rapid ventricular pacing. Evaluation Patient screening, especially regarding native aortic annulus diameter and pattern of calcification, is essential for success. Since imaging is crucial, Implantations are optimally performed in a hybrid operative theater by an experienced team of cardiac surgeons, cardiologists, and anesthetists. Conclusions The aim of this article is to outline the technical aspects of the new technique of minimally invasive transapical aortic valve Implantation.