Transcatheter aortic valve implantation facilitated by right common carotid cut-down and innominate artery angioplasty with simultaneous right coronary artery vein graft percutaneous coronary intervention in a patient with mid aortic syndrome: a case report. Issue 4 (26th May 2020)

• Record Type: Journal Article
• Authors: Ghobrial, Mina S A; Khan, Kamal; Baguneid, Mohamed; Levy, Richard D
• Editors: Camm, Christian Fielder; Kanakakis, John; Dimitriadis, Kyriakos; Hasan, Hosam; Vamvakidou, Anastasia; Green, Peregrine
• Is Part Of: European heart journal. Volume 4:Issue 4(2020)
• Page Start: 1
• Page End: 5
• Publication Date: 2020-05-26
• Subjects: TAVI -- Mid aortic syndrome -- Complex angioplasty -- Innominate artery angioplasty -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytaa134
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Transcatheter aortic valve implantation (TAVI) is most commonly performed via the femoral approach. Small caliber ilio-femoral arteries, severe calcification and tortuosity are often prohibitive reasons for TAVI via the femoral approach. Mid-aortic syndrome is a rare condition describing congenital or acquired coarctation of the abdominal aorta. Case summary: To the best of our knowledge, this case report describes the world's first TAVI in a patient with mid-aortic syndrome with challenging vascular access that would preclude conventional TAVI access routes. A 76-year-old woman with intermittent claudication, underwent work-up for axillo-bifemoral bypass, underwent a TAVI for incidental severe asymptomatic severe aortic stenosis via right common carotid TAVI facilitated by innominate artery angioplasty achieved vascular access for TAVI. Percutaneous coronary intervention to a right coronary artery vein graft was simultaneously performed via a left brachial artery cut down. Discussion: We demonstrate that complex angioplasty to coronary artery bypass grafts and the innominate artery alongside TAVI via a variety of arterial access sites is both safe and feasible.