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10.5606/tgkdc.dergisi.2015.10634
Transcatheter valve implantation into descending aorta due to the insufficient guide wire support
Serkan Aslan, Derya Öztürk, Mehmet Gül, Ömer Çelik, Nevzat Uslu
Department of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10634
Transcatheter aortic valve implantation (TAVI) is an
alternative therapy to surgical aortic valve replacement in
inoperable patients with severe aortic stenosis. Despite the
increasing use of TAVI currently, the potential risk for lifethreatening
complications is still regarded to be high. An
86-year-old female patient was admitted to our clinic with
angina. On echocardiography, the mean transaortic gradient
was 55 mmHg with a calculated aortic valve area of 0.8 cm2.
Due to high surgical risk scores (Logistic EuroSCORE=
31.21%), the patient was scheduled for TAVI via transfemoral
route. An Amplatz Super Stiff PTFE-coated Guide wire (7 cm
Bentson-Type) was positioned correctly into the left ventricle.
Predilatation was made into the aortic root by balloon.
A 23 mm Edwards SAPIEN XT valve was advanced to the
aorta, however, the valve was unable to be placed at the aortic
valve level due to the retraction of the guide wire from the
left ventricle. The transcatheter aortic valve was withdrawn
and implanted to the descending aorta. Subsequently, another
transcatheter aortic valve (23 mm Edwards SAPIEN XT) was
implanted at the aortic valve level successfully.
Keywords : Aort stenosis; complication of transcatheter aortic valve implantation; transcatheter aortic valve implantation
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