In high-risk patients with pure native aortic regurgitation (PNAR), transcatheter aortic valve replacement (TAVR) remains an off-label intervention. Due to anatomical variations in the aortic root and technical challenges unique to PNAR, the transfemoral approach (TF-TAVR) requires continued accumulation of experience and technological refinement. In this context, we successfully and safely performed a snare-assisted TF-TAVR procedure for a patient with PNAR, characterized by significant aortic angulation. We introduced an innovative technique termed "snare-assisted coaxiality optimized technique" (SACOT) during valve deployment. SACOT played a crucial role in optimizing valve positioning, enhancing coaxiality, and achieving the ideal implantation depth for PNAR. Post-procedure assessments demonstrated stability and the absence of paravalvular regurgitation (PVR).
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http://dx.doi.org/10.3389/fcvm.2024.1383264 | DOI Listing |
Front Cardiovasc Med
May 2024
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
In high-risk patients with pure native aortic regurgitation (PNAR), transcatheter aortic valve replacement (TAVR) remains an off-label intervention. Due to anatomical variations in the aortic root and technical challenges unique to PNAR, the transfemoral approach (TF-TAVR) requires continued accumulation of experience and technological refinement. In this context, we successfully and safely performed a snare-assisted TF-TAVR procedure for a patient with PNAR, characterized by significant aortic angulation.
View Article and Find Full Text PDFEur Heart J Case Rep
November 2023
Department of Cardiology, Gifu Heart Center, Gifu, Japan.
Background: We previously reported a case of successful percutaneous left atrial appendage closure (LAAC) for complex left atrial appendage (LAA) morphology using a handmade double-curve delivery sheath (DS) reshaped by a heat gun. However, whether the reshaped curve was appropriately adjusted as an optimal configuration for this patient's anatomy remained uncertain.
Case Summary: We established the LAAC procedural simulation model supported by virtual reality (VR) technology.
Eur Heart J Case Rep
September 2023
Division of Cardiology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Osaka, Sakai 591-8025, Japan.
Background: In transcatheter aortic valve implantation (TAVI) using a SAPIEN3 balloon-expandable valve (S3), wire withdrawal from the left ventricle (LV) during the procedure before deployment can induce vascular injury in the access site or require surgical treatment when an S3 removal is attempted. We present a successful case of bailout from this situation safely with a minimally invasive technique using a 6-F snare catheter (SC).
Case Summary: An 86-year-old woman with severe aortic stenosis underwent trans-femoral TAVI using an S3 under conscious sedation.
Micromachines (Basel)
March 2022
State Key Lab of Mechanics and Control of Mechanical Structures, School of Aeronautics, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China.
Cardiovascular diseases (CVDs) are the deadliest diseases worldwide. Master-slave robotic systems have been widely used in vascular interventional surgery with the benefit of high safety, efficient operation, and procedural facilitation. This paper introduces a remote-controlled vascular interventional robot (RVIR) that aims to enable surgeons to perform complex vascular interventions reliably and accurately under a magnetic resonance imaging (MRI) environment.
View Article and Find Full Text PDFArtif Organs
July 2021
Department of Mechanical Engineering, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil.
Transcatheter aortic valve implantation (TAVI) is an increasingly widespread procedure. Although this intervention is indicated for high and low surgical risk patients, some issues still remain, such as prosthesis positioning optimization in the aortic annulus. Coaxial positioning of the percutaneous prosthesis influences directly on the aortic wall stress map.
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