Percutaneous aortic valve replacement in patients with challenging aortoiliofemoral access

Percutaneous aortic valve replacement (PAVR) offers considerable promise in treating high risk patients with aortic valve disease. Two devices are currently clinically available for transfemoral delivery: the Edwards‐Sapien balloon‐expandable bioprosthesis and the Corevalve self‐expanding bioprosthe...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2008-11, Vol.72 (6), p.885-890
Main Authors: Jilaihawi, Hasan, Spyt, Tomasz, Chin, Derek, Logtens, Elaine, Laborde, Jean-Claude, Kovac, Jan
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aorta - pathology
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - pathology
Aortic Valve Stenosis - surgery
Bioprosthesis
Cardiac Catheterization - adverse effects
Catheterization, Peripheral - adverse effects
Clinical Competence
complications adult cath/intervention
Constriction, Pathologic
corevalve
Echocardiography, Doppler, Color
Female
Femoral Artery - pathology
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Humans
Iliac Artery - pathology
Male
Patient Selection
percutaneous aortic valve replacement (PAVR)
percutaneous aortic valve replacement (PAVR), transcatheter aortic valve implantation
peripheral vascular disease
Peripheral Vascular Diseases - complications
Peripheral Vascular Diseases - pathology
Peripheral Vascular Diseases - surgery
Prosthesis Design
Radiography, Interventional
Risk Assessment
transcatheter aortic valve implantation
Treatment Outcome
Ultrasonography, Interventional
valvular heart disease
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Summary:Percutaneous aortic valve replacement (PAVR) offers considerable promise in treating high risk patients with aortic valve disease. Two devices are currently clinically available for transfemoral delivery: the Edwards‐Sapien balloon‐expandable bioprosthesis and the Corevalve self‐expanding bioprosthesis, both of which require careful sizing of the peripheral vasculature. Through a case based discussion, we illustrate that these limits of PAVR technology can be stretched in cases of extraordinary clinical need. We demonstrate that, following a learning curve of “optimal cases,” successful PAVR is also possible in diffusely diseased peripheries of borderline small size or with focal aortoiliofemoral disease amenable to a separate intervention beforehand. © 2008 Wiley‐Liss, Inc.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.21630