Transcatheter Aortic Valve Implantation via the Right Subclavian Artery for Chronic Type A Aortic Dissection

Transcatheter aortic valve implantation (TAVI) in patients with chronic type A aortic dissection (CTAAD) is rare, and the optimal strategy remains undefined. An 86-year-old woman with symptomatic severe aortic stenosis underwent preprocedural computed tomography for TAVI before scheduled gastric cancer surgery, revealing CTAAD. To avoid the dissection flap, the right subclavian artery was selected as the access route, and a balloon-expandable valve was successfully implanted. The dissection cavity was located along the outer curvature of the ascending aorta. The right subclavian artery approach allowed effective avoidance of the dissection cavity. Balloon-expandable valves are less likely to interact with the dissection flap. Therefore, using a balloon-expandable valve via the right subclavian artery represents a favorable strategy for TAVI in patients with CTAAD. TAVI using a balloon-expandable valve via the right subclavian artery is an effective strategy for managing complex cases involving CTAAD.