TY - JOUR
AU - Zeus, Tobias
AB - An 84-year-old patient presented with symptomatic, severe aortic stenosis (New York Heart Association III, Class II angina). His medical history included a partially thrombosed infrarenal aortic aneurysm (max. Ø 4.9 cm) and severe peripheral artery disease with subsequent vascular surgery. Since the implanted aorto-bifemoral prosthesis only allowed a transfemoral access with concomitant surgical cut down, we chose a transcaval implantation strategy. Two potential targets were identified: the first one offered a small window within the heavily calcified infrarenal aorta and was situated 1.5 cm below the right renal artery (Panel A). The second one was located at the level of the infrarenal aortic aneurysm (Panels B and C). We decided to puncture the aneurysm due to: High-risk puncture of the first target site due to proximity to the renal artery, The thin arterial wall within the aneurysm may allow soft passage, and The thrombotic material potentially offers support for an effective closure. The valve was successfully implanted (Panels D and E) and the aortic puncture site was closed with an Amplatzer™ duct 10/8 occluder. Post-procedural computed tomography showed a good result with a small but acceptable fistula between the vena cava and the aorta (Panel F). Open in new tabDownload slide Open in new tabDownload slide (Panel A) First target site with proximity to the renal artery. (Panel B) Second target site: infrarenal aneurysm. (Panel C) Angiographic depiction of the aneurysm with thrombotic material (arrows). (Panel D) Snare of the crossing wire in intraluminal aortic position. (Panel E) Valve implantation. (Panel F) Computed tomography showing the occluder with a small fistula between the aorta and the vena cava. V.V. and T.Z. have received consulting fees, travel expenses or study honoraria from the following companies: Medtronic and Edwards outside of this work. All other authors have nothing to disclose. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - Transcaval aortic valve implantation through a partially thrombosed infrarenal aortic aneurysm
JO - European Heart Journal
DO - 10.1093/eurheartj/ehz164
DA - 2019-03-27
UR - https://www.deepdyve.com/lp/oxford-university-press/transcaval-aortic-valve-implantation-through-a-partially-thrombosed-pG0zPTyMEM
SP - 974
EP - 974
VL - 41
IS - 8
DP - DeepDyve
ER -