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EnglishBACKGROUND: 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the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta.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.
| Titolo: | How should i treat an unexpected deadlock at the time of transcatheter aortic valve prosthesis implantation? |
| Autore/i: | Dall'Ara, Gianni; Moretti, Carolina; Marrozzini, Cinzia; Taglieri, Nevio; Saia, Francesco; Marzocchi, Antonio; Witkowski, Adam; Kahlert, Philipp; Hildebrandt, Heike A.; Lind, Alexander Y.; Jánosi, Rolf Alexander; Rassaf, Tienush |
| Autore/i Unibo: | |
| Anno: | 2017 |
| Rivista: | |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.4244/EIJ-D-16-00902 |
| 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the operators were preparing for prosthesis deployment (Edwards SAPIEN 3), the extra-stiff guidewire was accidentally withdrawn from the left ventricle (LV) to the ascending aorta.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. |
| Data stato definitivo: | 2018-01-19T10:41:46Z |
| Appare nelle tipologie: | 1.01 Articolo in rivista |
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