The Atrium: Aortic Valve Replacement

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. Filip Casselman, Staff Surgeon and Co-Director of the Cardiovascular Center at OLV Clinic (AZORG), Aalst, Belgium, about aortic valve replacement (AVR).

Chapters

00:00 Intro

01:30 Why CT Surgery?

02:36 Anatomy

03:23 Pathology

06:15 History

09:06 Preoperative Planning

15:12 Indications

16:26 TAVR vs SAVR

20:25 Step-by-Step

41:25 Postop Management & Complications

46:32 Training Advice

The discussion explores the anatomy of the aortic valve, the pathology of aortic stenosis (AS) and aortic regurgitation (AR), and their respective echo grading, including complex cases like low-flow, low-gradient AS and bicuspid aortic valves. The conversation covers the history of AVR, preoperative planning—including prosthesis selection—and clinical indications for intervention in both symptomatic and asymptomatic severe aortic stenosis.

Furthermore, they compare transcatheter aortic valve replacement (TAVI) with surgical aortic valve replacement (SAVR). Technical aspects of the procedure were also addressed, from preparation and positioning to median or J-sternotomy approaches, cannulation, aortotomy, prosthesis sizing, managing patient-prosthesis mismatch, weaning from bypass, and chest closure. Finally, they provide insights into sutureless devices, postoperative management, and complications.

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Keep an eye out for next month’s episode.  

 

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