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Thorac Cardiovasc Surg 2013; 61(04): 336-339
DOI: 10.1055/s-0031-1295575
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Transcatheter Aortic Valve Implantation in Aortic Coarctation

René Schramm
1   Clinic of Cardiac Surgery, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
Christian Kupatt
2   Department of Internal Medicine I, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
Christoph Becker
3   Institute for Clinical Radiology, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
René Bombien
1   Clinic of Cardiac Surgery, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
Bruno Reichart
1   Clinic of Cardiac Surgery, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
Ralf Sodian
1   Clinic of Cardiac Surgery, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
,
Christoph Schmitz
1   Clinic of Cardiac Surgery, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
› Author Affiliations
Further Information

Publication History

20 May 2011

22 June 2011

Publication Date:
03 January 2012 (online)

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Abstract

A 77-year-old male patient was scheduled for transcatheter aortic valve implantation for symptomatic and severe aortic valve stenosis. Severe multidirectional kinking of the aorta based on aortic coarctation did not allow for the transfemoral, but only for the transapical approach. The procedure was complicated because of the technically challenging retrograde passage of the transfemorally inserted pig-tail catheter required for intraoperative angiography of the aortic root. Correct positioning of the pig-tail catheter into the ascending aorta was accomplished by use of a loop snare, which was advanced into the descending aorta via the antegrade route, passing the cardiac apex, the stenotic aortic valve, and the coarctation-associated kinking. The pig-tail catheter tip was manipulated into the loop snare, pulled traverse the coarctation, and released within the proximal ascending aorta. Subsequent procedures were uneventful and followed the standardized protocol. A 29 mm Edwards Lifescience transcatheter Sapien bioprosthesis was successfully implanted.

Keywords

aorta/aortic - aortic valve and root - cardiac anatomy/pathologic
 

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