Direct aortic transcatheter aortic valve implantation [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(7): 585-587 | DOI: 10.5543/tkda.2021.21018

Direct aortic transcatheter aortic valve implantation

Emir Karaçağlar1, Arzu Neslihan Akgün1, Alp Aydınalp1, Deniz Sarp Beyazpınar2, Atila Sezgin2, Haldun Müderrisoğlu1
1Department of Cardiology, Başkent University School of Medicine, Ankara, Turkey
2Department of Cardiovascular Surgery, Başkent University School of Medicine, Ankara, Turkey

Transcatheter aortic valve implantation (TAVI) is a safe and effective alternative to surgical valve replacement in intermediate and even in low‐risk patient cohorts. Direct aortic (DAo) route may be used in patients with severe peripheral vascular disease. Here, we present an 88-year old patient hospitalized with cardiogenic shock. Echocardiography revealed severe aortic valve stenosis with aortic valve area 0.5 cm², mean gradient of 55 mmHg, and peak gradient 92 mmHg. TAVI was considered by the Institutional Heart Team. Multislice computed tomography (MSCT) revealed severe peripheral vascular disease, decreased calibration of abdominal aorta, and multiple large vulnerable atherosclerotic plaques. The patient was scheduled for a DAo TAVI. A 26-mm Medtronic CoreValve Evolut R valve was implanted after predilatation with median sternotomy. The patient was discharged after 96 hours. Although transfemoral (TF) access is used as the default approach for TAVI, it was contraindicated in our patient owing to severe peripheral vascular disease and decreased calibration of the abdominal aorta at its narrowest point (4.5 mm) with multiple large vulnerable atherosclerotic plaques. Careful preprocedural MSCT evaluation is essential and directly affects the success of the procedure. MSCT is also mandatory to confirm the best cannulation zone that must be met for a successful DAo TAVI.

How to cite this article
Emir Karaçağlar, Arzu Neslihan Akgün, Alp Aydınalp, Deniz Sarp Beyazpınar, Atila Sezgin, Haldun Müderrisoğlu. Direct aortic transcatheter aortic valve implantation. Turk Kardiyol Dern Ars. 2021; 49(7): 585-587

Corresponding Author: Emir Karaçağlar, Türkiye
© Copyright 2021 Archives of the Turkish Society of Cardiology
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