BACKGROUND: An 80-year-old man with symptomatic severe aortic valve stenosis, haemodynamic instability, important comorbidities and a high surgical risk. Following bridgeballoon aortic valvuloplasty to recover from the unstable haemodynamics he was deemed suitable for transcatheter aortic valve implantation (TAVI) via the femoral access route. INVESTIGATION: Fluoroscopy. DIAGNOSIS: During TAVI, while the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta. MANAGEMENT: Valve orifice was re-crossed from the contralateral access, a snare was introduced through the AL1 catheter and pushed anterogradely through the valve. The extra-stiff wire was then captured in the ascending aorta and pulled back into the LV to complete the procedure.
Dall'Ara, G., Moretti, C., Marrozzini, C., Taglieri, N., Saia, F., Marzocchi, A., et al. (2017). How should i treat an unexpected deadlock at the time of transcatheter aortic valve prosthesis implantation?. EUROINTERVENTION, 13(2), e256-e258 [10.4244/EIJ-D-16-00902].
How should i treat an unexpected deadlock at the time of transcatheter aortic valve prosthesis implantation?
Dall'Ara, Gianni;Moretti, Carolina;Taglieri, Nevio;Saia, Francesco;Marzocchi, Antonio;
2017
Abstract
BACKGROUND: An 80-year-old man with symptomatic severe aortic valve stenosis, haemodynamic instability, important comorbidities and a high surgical risk. Following bridgeballoon aortic valvuloplasty to recover from the unstable haemodynamics he was deemed suitable for transcatheter aortic valve implantation (TAVI) via the femoral access route. INVESTIGATION: Fluoroscopy. DIAGNOSIS: During TAVI, while the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta. MANAGEMENT: Valve orifice was re-crossed from the contralateral access, a snare was introduced through the AL1 catheter and pushed anterogradely through the valve. The extra-stiff wire was then captured in the ascending aorta and pulled back into the LV to complete the procedure.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
