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Eur J Cardiothorac Surg 2003;23:156-158
© 2003 Elsevier Science NL

Off-pump apicoaortic conduit insertion for high-risk patients with aortic stenosis

The Pensacola Heart Institute, Pensacola, FL 32504, USA

Received 9 September 2002; received in revised form 23 October 2002; accepted 28 October 2002.

* 5151 North Ninth Avenue, Suite 200, Pensacola, FL 32504, USA. Tel.: +1-850-857-1734; fax: +1-850-857-1745

Objectives: Recently, we implanted an apicoaortic conduit off-pump in three high-risk patients with severe aortic stenosis. Methods: A muscle-coring device was utilized to create the apical outflow tract followed by insertion of a rigid apical connector. A valved conduit was then connected to the descending thoracic aorta and to the apical connector graft. Results: A stentless porcine bioprosthesis was implanted in two patients and a stented valve in one. The left ventricular (LV)-aortic gradients were reduced from a mean of 66 to 28 mmHg. Conclusions: With modification of an existing technique, apicoaortic conduit insertion can be performed safely off-pump. This technique can be applied to complex forms of LV outflow obstruction and high-risk patients.

Key Words: Aorta • Heart valve prosthesis

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