Transcatheter valve-in-valve aortic valve replacement with bioprosthetic valve Fracture/Stretching technique in a degenerated mitroflow valve.

We describe a successful bioprosthetic annular stretching in a patient with severe prosthetic aortic valve stenosis from a degenerated 19-mm Mitroflow valve (Sorin Group USA Inc, Arvada, CO, USA). This technique allowed for implantation of a 23-mm Evolut-R Pro valve (Medtronic, Minneapolis, MN, USA) with significant improvement in hemodynamics after prosthetic annular stretching. We have also summarized other case series and case reports which have previously described similar techniques.

Iliofemoral peripheral orbital atherectomy for optimizing TAVR access: An innovative strategy in the absence of alternative access options.

Suboptimal iliofemoral artery access requiring alternative trans-catheter aortic valve replacement (TAVR) access is still encountered in 10-20% of subjects undergoing TAVR. Attempting suboptimal vascular access may result in excessive vessel injury, bleeding and even death. Reported is an innovative procedure to address suboptimal heavily calcified iliofemoral access by using Diamondback 360 peripheral orbital atherectomy (POA) to ablate heavy endoluminal vascular calcifications followed by balloon angioplasty.

Arteriotomy site complication during transcatheter aortic valve replacement: Ipsilateral wire protection and bailout.

Major vascular complications still occur in ~4.2% of transcatheter aortic valve replacement (TAVR) procedures. These complications are a major safety drawback of TAVR when compared to surgical aortic valve replacement (SAVR).