Journal Article

Case report of snaring-assisted TAVR under cerebral embolic protection: the “Chaperone” with “Top Hat” technique

Casilli, Francesco, Bande, Marta, Donatelli, Francesco, Medda, Massimo, Tespili, Maurizio

2023

Overview

Symptomatic severe aortic stenosis (AS) in patients with intermediate-to-high surgical risk is currently being treated with transcatheter aortic valve replacement (TAVR). We present a case of a TAVR in a severe calcific AS with porcelain aorta and ‘gothic’ aortic arch. Pre-operative thoraco-abdominal computed tomography angiography showed also severe calcification at the sinotubular junction with protruding huge calcified nodules extending in ascending aorta and multiple calcific stenosis of both iliac-femoral vessels, severely tortuous. The choice of the interventional access was not easy and the high risk of an acute intra-procedural brain event guided the procedural planning. To our knowledge, this is the first case of TAVR with complete cerebral protection with Triguard system device and ‘snaring-assisted’ valve advancement.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: aortic valve stenosis / Calcification / Cardiology / Cardiovascular Medicine / cerebral protection devices / chaperone technique / Conflicts of interest / Coronary vessels / Medical imaging / snare catheter / Tomography / transcatheter aortic valve replacement (TAVR)