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Catheter Cardiovasc Interv ; 103(7): 1088-1092, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38639156

ABSTRACT

Coronary obstruction during transcatheter aortic valve replacement (TAVR) poses a significant threat, prompting a closer examination of prevention and bailout strategies. Following TAVR deployment with a coronary artery obstruction complication and recognizing the complexities involved in engaging the left main coronary artery through TAVR cells. This case introduces the "Ping-pong" technique using a second guide catheter. When faced with difficulty in engaging the catheter through TAVR cells, an innovative solution is proposed. Inserting a wire into the valsalva and utilizing a rapid inflate-deflate balloon maneuver successfully facilitates catheter access into the left main, offering a promising intervention for challenging scenarios. In conclusion, this study emphasizes the severe implications of coronary obstruction during TAVR. The innovative "Ping-pong" technique and rapid inflate-deflate balloons emerge as valuable interventions, showcasing their potential in challenging catheter engagement scenarios. These insights offer a promising avenue for enhancing patient outcomes in TAVR procedures.


Subject(s)
Aortic Valve Stenosis , Coronary Occlusion , Transcatheter Aortic Valve Replacement , Humans , Aortic Valve Stenosis/surgery , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/physiopathology , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/instrumentation , Treatment Outcome , Coronary Occlusion/diagnostic imaging , Coronary Occlusion/etiology , Coronary Occlusion/therapy , Coronary Occlusion/physiopathology , Balloon Valvuloplasty/adverse effects , Aged, 80 and over , Cardiac Catheters , Heart Valve Prosthesis , Aortic Valve/surgery , Aortic Valve/physiopathology , Aortic Valve/diagnostic imaging , Coronary Angiography , Male , Female
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