Key result
Transcarotid TAVR was performed safely without cerebral vascular events and with preserved renal function in an octogenarian with complex type B aortic dissection and advanced CKD.
Why the study?
Can transcarotid TAVR be performed safely in a patient with severe aortic stenosis, advanced CKD, and complex type B aortic dissection?
Case Report (n=1)
Can transcarotid TAVR be performed safely in a patient with severe aortic stenosis, advanced CKD, and complex type B aortic dissection?
Transcarotid TAVR using 3D transesophageal echocardiography for sizing is a feasible and safe alternative for patients with severe aortic stenosis, advanced CKD, and complex aortic dissection.
May offer a feasible access route in complex anatomy with CKD; hypothesis-generating case report requiring prospective validation.
We report the case of an octogenarian with severe aortic valve stenosis, chronic kidney disease (CKD) and heart failure. Due to advanced CKD, we used a 3-dimensional transesophageal echocardiogram for sizing the device before transcatheter aortic valve replacement (TAVR). Noncontrast computed tomography found complex aortic dissection involving the arch, descending thoracic aorta, and abdominal aorta. TAVR was approached via the right carotid artery using a CoreValve. There was no cerebral vascular event. Renal function was well preserved. Transcarotid TAVR can be performed safely with complex type B aortic dissection. Three-dimensional transesophageal echocardiogram provides an alternative sizing solution in advanced CKD.
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Liang et al. (2021) conducted a case report in Severe aortic valve stenosis, chronic kidney disease, heart failure, and complex type B aortic dissection (n=1). Transcarotid transcatheter aortic valve replacement (TAVR) using a CoreValve and 3D TEE sizing was evaluated on Cerebral vascular events and renal function preservation. Transcarotid TAVR was performed safely without cerebral vascular events and with preserved renal function in an octogenarian with complex type B aortic dissection and advanced CKD.
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