Totally Endoscopic Approach for TAVR Explantation and Subsequent Surgical AVR Using a 3D Endoscope System.

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. Exc

SUBMITTER: Kim JY 

PROVIDER: S-EPMC12441549 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature