Transcaval access for TAVR across a polyester aortic graft
2014; Wiley; Volume: 85; Issue: 7 Linguagem: Inglês
10.1002/ccd.25781
ISSN1522-726X
AutoresRobert J. Lederman, William W. O’Neill, Adam B. Greenbaum,
Tópico(s)Aortic Disease and Treatment Approaches
ResumoTranscaval access to the aorta allows transcatheter aortic valve replacement in patients without other good access options. The resulting aorto-caval fistula is closed with a nitinol cardiac occluder device. There is no experience traversing a synthetic aortic graft to perform transcaval access and closure. We describe a patient who underwent successful traversal of a polyester aortic graft using radiofrequency energy applied from the tip of a guidewire, to allow retrograde transcatheter aortic valve replacement from a femoral vein, along with details of our technique. The patient did well and was discharged home after 3 days. There was residual aorto-caval fistulous flow immediately after implantation of a polyester-seeded nitinol muscular ventricular septal defect occluder device, but this fistula spontaneously occluded within one month.
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