Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 May 14;22(1):29-31.
doi: 10.1016/j.jccase.2020.04.005. eCollection 2020 Jul.

Coronary angioplasty post TAVI: Is the solution outside the box?

Petros S Dardas  1 , Efstratios K Theofilogiannakos  1 , Dimitris Tsikaderis  1 , Nikos E Mezilis  1
Affiliations
Case Reports

Coronary angioplasty post TAVI: Is the solution outside the box?

Petros S Dardas et al. J Cardiol Cases. .

Abstract

Transcatheter aortic valve replacement (TAVR) has become the standard option for high risk patients with bioprosthetic valve degeneration. However, percutaneous coronary interventions after TAVR may be challenging as the manipulation and engagement of the guiding catheters is much more limited and difficult, due to the superimposition of the metallic frame of the TAVR valve upon the bioprosthetic cage. We describe a case of percutaneous coronary intervention in a patient with history of transcatheter aortic valve implantation after bioprosthetic valve degeneration and we describe a new method for accessing coronary arteries in cases of TAVR-in-surgical aortic valve replacement with a high-frame TAVR with a supra-annular leaflet position, by using the route outside the frame. 〈Learning objective: We describe a method for accessing coronary arteries in cases of transcatheter aortic valve implantation (TAVI)-in-surgical aortic valve replacement with a high-frame TAVI with a supraannular leaflet position, by using the route outside the frame.〉.

Keywords: PCI; TAVI.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
(A) Severely calcified subtotally occluded right coronary artery (RCA). (B) JR4 vertical to RCA ostium; Dual-lumen SASUKE microcatheter outside the guide catheter. (C) GUIDEZILLA advancement until mid RCA with the support of an inflated balloon distally. (D) Final angiographic result.
Fig. 2
Fig. 2
(A) A schema to show a new method for accessing coronary arteries in cases of transcatheter aortic valve implantation (TAVI)-in-surgical aortic valve replacement with a high-frame TAVI with a supraannular leaflet position, by using the route outside the frame. (B) A computed tomography angiography showed very good apposition of the EVOLUT frame to the aortic wall after percutaneous coronary intervention.
See this image and copyright information in PMC

References

    1. Patel M.R., Calhoon J.H., Dehmer G.J., Grantham J.A., Maddox T.M., Maron D.J. ASNC/SCAI/SCCT/STS 2017 appropriate use criteria for coronary revascularization in patients with stable ischemic heart disease: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons. Coronary Revascularization Writing Group. J Nucl Cardiol. 2017;24:1759–1792. - PubMed
    1. Søndergaard L., De Backer O. Transcatheter aortic valve implantation: don’t forget the coronary arteries! Eurointervention. 2018;14:147–149. - PubMed

Publication types

LinkOut - more resources