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You are here: Contents > 2018-19 > Volume 27 Number 5 (2018-19) > CASE REPORT > Snare Technique to Facilitate TAVI in a Highly Calcified Aortic Valve with Horizontal Anatomy

Snare Technique to Facilitate TAVI in a Highly Calcified Aortic Valve with Horizontal Anatomy

Athanasios Kolyviras1,2, Dimitrios Damaskos1, Vaios Tzifos1

1Henry Dunant Hospital Center, Department of Interventional Cardiology, Athens, Greece
2Electronic correspondence: kolyvirasthanos@hotmail.com

Transcatheter aortic valve implantation (TAVI) is a rapidly evolving procedure with great advances in technique and technology. However, the procedure is always challenging when dealing with elderly patients with severe calcified aortic leaflets and a horizontal aorta. A case is described where a new technique using a snare catheter to assist in crossing the native aortic valve was employed. The technique can provide a safe solution, is easily performed, and facilitates success of the procedure in patients that otherwise may require surgical treatment on an emergency basis.

Video 1: The buddy-balloon technique. A second Safari wire was placed in the left ventricle from the contralateral femoral artery. A 22 mm balloon was advanced over the second Safari wire. The balloon was rapidly inflated and deflated and at the deflation time. The procedure was unsuccessful when trying to advance the Portico valve.

Video 2: The snare technique. The nose cone of the Portico valve is pulled by the snare catheter, and the whole system is centralized in order to achieve co-axiality with the aortic orifice. The Portico valve is successfully crossed by the native aortic valve.

Video 3: Final result after post-dilatation with a 22 mm balloon. Good angiographic result with mild aortic regurgitation.

The Journal of Heart Valve Disease 2018-19;27:304-305

Snare Technique to Facilitate TAVI in a Highly Calcified Aortic Valve with Horizontal Anatomy

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