Krisper, M: Implantation of an aortic bioprosthesis: Visuali

The new 3f ENABLE (TM) Aortic Bioprosthesis, a self expanding stentgraft device that does not require full suturing in is prone to shorten the otherwise time consuming procedure of aortic valve replacement. In this study, which was conducted with cadaver hearts, special focus has been laid on the visualization of the process of implantation. Endoscopic tools were introduced via the apex of the heart during the implantation and afterwards, and video- and photographic data were collected. The trial showed that accurate positioning is critical, since tilting or size-mismatches will unevitably create leakage, however small they may be. Repositioning will regularly be necessary and must be done carefully, for tight sealing in the annulus is a key factor. A learning curve was evident in our study and indicates the need for good training of the surgeon in charge. Including multiple rerrangement manoeuvers necessary for optimal positioning it seems overall implantation time is comparable to fully sutured-in standard implantation techniques. Coronary occlusion has not been a problem in our session.