Key result
Antegrade TAVR using bilateral arm access for a veno-arterial loop was successfully performed in a patient with a totally occluded abdominal aorta and failed apical access.
Case Report (n=1)
Demonstrates the feasibility of a novel antegrade TAVR approach using bilateral arm access for patients with totally occluded abdominal aorta and failed apical access.
May expand bailout options for antegrade TAVR in prohibitive anatomy; hypothesis-generating and requires prospective validation.
The antegrade approach for aortic valve interventions is well known but has not been widely used for transcatheter aortic valve replacement (TAVR) procedures. We encountered a patient with no possibility of retrograde access due to a totally occluded abdominal aorta who had a failed attempt at apical TAVR. We describe antegrade TAVR despite occlusion of the abdominal aorta, with the arterial limb of the requisite veno-arterial loop created using bilateral arm access, a novel version of the previously described antegrade approach.
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Levisay et al. (2013) conducted a case report in Aortic valve disease with totally occluded abdominal aorta (n=1). Antegrade TAVR using bilateral arm access was evaluated. Antegrade TAVR using bilateral arm access for a veno-arterial loop was successfully performed in a patient with a totally occluded abdominal aorta and failed apical access.
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