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Image in Cardiology
Preventing coronary occlusion with a retrievable aortic valve
Prevenção da oclusão coronária com uma válvula aórtica recuperável
Raul Morenoa,
Autor para correspondência
raulmorenog@hotmail.com

Corresponding author.
, Maria del Carmen Monederoa, Santiago Jiménez-Valeroa, Luis Calvo Orbea, Jean Claude Labordeb, José Luis López-Sendóna
a Hospital La Paz, Madrid, Spain
b St George's Hospital, London, England, United Kingdom
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Coronary occlusion is one of the potential complications during transcatheter aortic valve implantation&#46; Second-generation fully retrievable and repositionable devices can theoretically prevent this complication&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 81-year-old woman with symptomatic aortic stenosis &#40;valve area 0&#46;52 cm<span class="elsevierStyleSup">2</span>&#59; peak and mean gradients 118 and 70 mmHg&#44; respectively&#59; normal ejection fraction&#41; was referred for transcatheter aortic valve implantation&#46; Although her surgical risk was acceptable &#40;logistic euroSCORE 8&#37;&#41;&#44; open surgery was rejected due to porcelain aorta&#46; Preprocedural assessment included coronary angiography &#40;normal coronary arteries&#41; and cardiac computed tomography &#40;aortic annulus 21 mm&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 23 mm Lotus device &#40;Boston Scientific&#41; was implanted&#46; After an 18 F sheath was advanced through the right femoral artery&#44; percutaneous aortic valvuloplasty was performed using an 18 mm balloon and a Safari guidewire&#46; The delivery system and the unexpanded valve were advanced retrogradely to the left ventricular cavity &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41; and manually controlled expansion of the valve was performed &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">After complete expansion of the valve&#44; the aortic angiogram showed apparent occlusion of the left main due to the slightly high position of the valve &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#41;&#46; Due to the possibility of resheathing the Lotus device even after it had been completely expanded&#44; the valve was retrieved and repositioned in a lower position&#44; without compromising the left main &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B&#41;&#44; thus allowing final release of the valve &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">This case illustrates the potential advantages of second-generation devices for transcatheter aortic valve implantation&#46; With the Lotus device&#44; retrieval and repositioning are possible even when the valve has been completely expanded and positioned&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Delivery system containing the unexpanded Lotus valve through the aortic valve&#59; &#40;B&#41; the Lotus valve partially expanded&#46;</p>"
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Informação do artigo
ISSN: 08702551
Idioma original: Inglês
DOI:10.1016/j.repc.2015.01.011
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