Transcatheter aortic valve replacement (TAVR) has become a common theraputic option for aortic stenosis, but the evidence for precise anatomy for TAVR is accumulating. This paper presents the case of an 71-year-old female patient who had an extremely high risk of coronary obstruction due to both coronary ostia lying too low. The patient underwent TAVR with the help of coronary protection successfully. During the procedure, the patient was protected with wires only for both coronaries. After deployment, angiofluoroscopy suggested that chimney stenting should be applied for left coronary. The whole procedure was unenventful and both coronaries were seen.
Citation：
ZHU Bo, ZHONG Yi, XIA Meng, FAN Zhongcai. A case of transcatheter aortic valve replacement with right-&-left coronary protection. West China Medical Journal, 2022, 37(4): 491-495. doi: 10.7507/1002-0179.202203027
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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Arai T, Lefèvre T, Hovasse T, et al. Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world. Catheter Cardiovasc Interv, 2017, 90(7): 1192-1197.
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Palmerini T, Chakravarty T, Saia F, et al. Coronary protection to prevent coronary obstruction during TAVR: a multicenter international registry. JACC Cardiovasc Interv, 2020, 13(6): 739-747.
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Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry. Eur Heart J, 2018, 39(8): 687-695.
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Mercanti F, Rosseel L, Neylon A, et al. Chimney stenting for coronary occlusion during TAVR: insights from the chimney registry. JACC Cardiovasc Interv, 2020, 13(6): 751-761.
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Khan JM, Babaliaros VC, Greenbaum AB, et al. Preventing coronary obstruction during transcatheter aortic valve replacement: results from the multicenter international BASILICA registry. JACC Cardiovasc Interv, 2021, 14(9): 941-948.
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- 1. 张怡, 熊恬园, 陈茂. 《2021 ESC/EACTS心脏瓣膜病管理指南》解读: 经导管瓣膜治疗策略的更新. 中国胸心血管外科临床杂志, 2021, 28(12): 1400-1408.
- 2. Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: a population-based survey. BMC Cardiovasc Disord, 2021, 21(1): 339.
- 3. Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol, 2020, 76(21): 2492-2516.
- 4. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021版). 中国介入心脏病学杂志, 2022, 30(1): 7-16.
- 5. Arai T, Lefèvre T, Hovasse T, et al. Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world. Catheter Cardiovasc Interv, 2017, 90(7): 1192-1197.
- 6. Palmerini T, Chakravarty T, Saia F, et al. Coronary protection to prevent coronary obstruction during TAVR: a multicenter international registry. JACC Cardiovasc Interv, 2020, 13(6): 739-747.
- 7. Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry. Eur Heart J, 2018, 39(8): 687-695.
- 8. Mercanti F, Rosseel L, Neylon A, et al. Chimney stenting for coronary occlusion during TAVR: insights from the chimney registry. JACC Cardiovasc Interv, 2020, 13(6): 751-761.
- 9. Khan JM, Babaliaros VC, Greenbaum AB, et al. Preventing coronary obstruction during transcatheter aortic valve replacement: results from the multicenter international BASILICA registry. JACC Cardiovasc Interv, 2021, 14(9): 941-948.
