Key result
Transcarotid TAVR was successfully performed in a 60-year-old man with severe aortic stenosis and chronic dialysis, improving his symptoms from NYHA class III to I at 12 months without major cardiovascular adverse events.
Why the study?
TAVR through the carotid artery in middle-aged patients with severe aortic stenosis and chronic hemodialysis is challenging due to the complex technique.
Case Report (n=1)
No
Transcarotid TAVR is a feasible and safe alternative for patients with severe aortic stenosis, chronic dialysis, and unfavorable transfemoral access.
May support transcarotid TAVR feasibility in dialysis patients with severe AS; hypothesis-generating, requires larger studies.
Transcatheter aortic valve replacement (TAVR) through the carotid artery in middle-aged patients with severe aortic stenosis and chronic hemodialysis has been a challenge in clinical practice because of the complex technique. A 60-year-old man was admitted to our hospital because of his symptomatic severe aortic stenosis. With the high risk of open surgery due to chronic hemodialysis, TAVR was selected after an in-depth discussion between the heart team and the patient. The transfemoral access route was not appropriate due to severe calcifications and tortuous iliofemoral arteries, therefore, the left carotid route was chosen. A 29-mm CoreValve Evolut R system was successfully implanted without any complications. His symptoms significantly improved at 12-month follow-up, without any major cardiovascular adverse events. TAVR via the carotid artery thus demonstrates the feasibility, safety, and effectiveness in such complex conditions.
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Vo et al. (2022) conducted a case report in Severe aortic stenosis and chronic dialysis (n=1). Transcatheter aortic valve replacement (TAVR) via the left carotid artery was evaluated on Symptom improvement and major cardiovascular adverse events. Transcarotid TAVR was successfully performed in a 60-year-old man with severe aortic stenosis and chronic dialysis, improving his symptoms from NYHA class III to I at 12 months without major cardiovascular adverse events.
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