Transfemoral Transcatheter Aortic Valve Replacement in a Patient with a History of Artificial Aortic Arch Replacement and Stent Implantation: a Case Report and Strategies for a Super-Stiff Approach

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ID: 315414
2026
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Ranked #207 of 261 articles by views in European Heart Journal - Case Reports

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Abstract
Abstract Background Transfemoral transcatheter aortic valve replacement (TAVR) is challenging in patients with stiff and tortuous anatomy. In the present case, we presented a patient with super stiff aortic arch (prior history of aortic arch replacement, stent implantation and anastomotic fistula plugging) and a summary of strategies for managing such stiff approach. Case summary A 59-year-old man with symptomatic severe aortic stenosis and a super-stiff aortic arch underwent transfemoral TAVR. Techniques including buddy wire, balloon deflection, balloon-assisted tracking, snare assistance, and long sheath use were considered. Balloon-assisted tracking combined with a long sheath ultimately enabled successful TAVR. Supra-annular anchoring was also confirmed in this case. Discussion For patients with extremely stiff anatomy, multiple techniques may facilitate successful transfemoral TAVR. Furthermore, in bicuspid aortic valve cases, the narrowed supra-annular region can serve as an effective anchoring zone.
Reference Key
openalex_W7162872196 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Yifan Yang, Y U N F E N Yan, J I N G Yao, Xinmin Liu, Guangyuan Song
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag388
URL
https://doi.org/10.1093/ehjcr/ytag388
Keywords Keywords not found

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