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the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta.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.
How should i treat an unexpected deadlock at the time of transcatheter aortic valve prosthesis implantation?
Dall'Ara, Gianni;Moretti, Carolina;Taglieri, Nevio;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the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta.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.
