Article Text
Abstract
A 70s woman with a history of open-heart surgery presented with severe aortic stenosis (AS). CT showed chronic type B aortic dissection (TBAD) between the distal aortic arch and the left common iliac artery. After careful consideration, we planned transfemoral (TF)-transcatheter aortic valve implantation (TAVI) using a 20-Fr long sheath to minimise number of contacts with the false lumen of the aorta. TAVI was performed under general anaesthesia, guided by transoesophageal echocardiography (TEE). A transcatheter aortic valve was successfully implanted. TEE immediately after valve implantation showed no remarkable changes in the descending thoracic aorta. Repeated postprocedural CT examinations showed no obvious changes in the aorta. The patient was stable without sequelae at the 12-month follow-up. This case demonstrates that TF-TAVI using a long sheath under TEE guidance can be a treatment option for patients with severe AS and chronic TBAD.
- interventional cardiology
- valvar diseases
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Footnotes
Twitter @Masaki Tsuda
Contributors Clinical care of this patient: MT, YE, MN and JT, Preparation of the manuscript: MT, YE, MN and JT. Final approval of the version to be submitted: MN.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.