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Eur J Cardiothorac Surg 2009;36:595-597. doi:10.1016/j.ejcts.2009.04.051
Copyright © 2009, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Enrico Ferrari
Ludwig Karl von Segesser
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Case reports

Transcatheter stent-valve implantation in a stenotic pulmonary conduit via a sub-xyphoidian access

Enrico Ferraria,*, Christopher Sulzerb, Elena Rizzoc, Ludwig Karl von Segessera

a Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
b Department of Anaesthesia, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
c Department of Radiology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland

Received 31 March 2009; received in revised form 15 April 2009; accepted 27 April 2009.

* Corresponding author. Address: Department of Cardiovascular Surgery, Centre Hôpitalier Universitaire Vaudois (CHUV), 46, rue du Bugnon, CH-1011 Lausanne, Switzerland. Tel.: +41 79 310 1386; fax: +41 21 314 2278. (Email: enricoferrari{at}bluewin.ch).

Patients who develop a severe stenosis in biological pulmonary conduits previously implanted for pulmonary outflow trunk reconstructions are treated either by surgical re-replacement, or by transcatheter stent-valve implantation through a femoral vein access. A catheter-based sub-xyphoidian access through the right ventricle for stent-valve positioning in a pulmonary conduit has rarely been proposed. We describe the case of a 20-year-old man who underwent a pulmonary trunk reconstruction for a congenital pulmonary valve dysplasia and a few years later developed a stenosis in the pulmonary conduit. He was successfully treated with a 23 mm Edwards Sapien© stent-valve implantation in pulmonary position, through an unusual right ventricular, sub-xyphoidian access and without contrast medium injections and pleura opening.

Key Words: Transcatheter valve replacement • Pulmonary conduit • Valve stenosis






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Copyright © 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.