Key result
Long-sheath supported transfemoral TAVR is effective in patients with tortuous aorta, but the tip of a large-bore sheath can cause aortic injury.
Why the study?
Transfemoral TAVR is challenging in patients with a tortuous aorta, and outcomes with a combined buddy wire and long-sheath approach needed description.
Is long-sheath assisted transfemoral TAVR safe and effective in patients with tortuous aorta?
Case Report (n=2)
Is long-sheath assisted transfemoral TAVR safe and effective in patients with tortuous aorta?
While a long-sheath supported transfemoral approach facilitates TAVR in tortuous aortas, operators must carefully weigh the risk of aortic injury, particularly in patients with fragile aortas.
Answers are grounded in this paper and cite their sources.
Variable outcomes warrant caution in tortuous aorta TAVR; leaves open safety of long-sheath techniques pending larger studies.
Transfemoral transcatheter aortic valve replacement (TAVR) is quite challenging in patients with tortuous aorta. Recently, the combined method of buddy wire and long-sheath use was reported. We describe 2 cases having tortuous aorta undergoing transfemoral TAVR following opposite clinical courses. A long-sheath supported transfemoral approach is an effective method in patients with tortuous aorta; however, the tip of a large-bore sheath could cause an aortic injury during the procedure. The advantage of the transfemoral approach and risk of aortic injury should be counterbalanced, especially in patients with fragile tortuous aorta.
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Higuchi et al. (2023) conducted a case report in Tortuous aorta undergoing transfemoral TAVR (n=2). Long-sheath supported transfemoral TAVR was evaluated on Clinical course and aortic injury. Long-sheath supported transfemoral TAVR is effective in patients with tortuous aorta, but the tip of a large-bore sheath can cause aortic injury.
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