Korean Circ J.  2018 Oct;48(10):949-950. 10.4070/kcj.2018.0129.

Successful Direct Iliac Transcatheter Aortic Valve Implantation to Overcome Significant Tortuosity of the Thoracic Aorta

• Kaneko U
• Kobayashi
• Hachinohe
• Sumino S
• Furugen A
• Kawamura T
• Doi H
• Fujita T

• KMID: 2420649
• DOI: http://doi.org/10.4070/kcj.2018.0129

Abstract

No abstract available.

MeSH Terms

Aorta, Thoracic*
Transcatheter Aortic Valve Replacement*

Figure

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  Figure 1 (A-C) Pre-procedural MDCT (A) Left anterior oblique view of maximum intensity projection showing a markedly tortuous thoracic aorta and no significant calcification around the acute bend (red arrows). (B) Posterior volume-rendering image of the aorta. (C) Volume-rendering image of the aorta showing the distance from the Rt.CFA (white bidirectional arrow) and the Rt.CIA (yellow bidirectional arrow) to the acute bend in the thoracic aorta. (D) Direct iliac approach. (E-H) Fluoroscopic images during the procedure. (E) Facilitating smooth insertion of the eSheath (yellow arrow) beyond the tortuous segment of the thoracic aorta (red arrows). (F) Successful implantation of the prosthetic valve. (G) Aortography showing trivial paravalvular leak. (H) Final aortography showing no vascular complication. MDCT = multi-detector computed tomography; Rt.CFA = right common femoral artery; Rt.CIA = right common iliac artery.

Reference

1. Aminian A, Lalmand J, El Nakadi B. Perforation of the descending thoracic aorta during transcatheter aortic valve implantation (TAVI): an unexpected and dramatic procedural complication. Catheter Cardiovasc Interv. 2011; 77:1076–1078.

2. de Agustin JA, Jiménez-Quevedo P, Nombela-Franco L, et al. Descending aorta rupture during transcatheter aortic valve replacement. Circulation. 2016; 133:e14–e17.