Increase Carotid Flow by Double Sheath Connection Technique to Reduce Cerebral Ischemia for Transcatheter Aortic Valve Implantation through Transcarotid Approach

Purpose: Transcarotid transcatheter aortic valve implantation (TAVI) is one alternative approach if unfavorable femoral access. However, this approach may cause cerebral vascular accidents (CVAs) by temporarily occluding common carotid artery (CCA). The purpose of this study is to develop a new meth...

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Detalles Bibliográficos
Autores principales: Tsai, Richard, Chen, I-Ming, Chen, Po-Lin, Leu, Hsin-Bang, Chen, Ying-Hwa, Chang, Hsiao-Huang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 2018
Materias:
New Method
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033524/
https://www.ncbi.nlm.nih.gov/pubmed/29628466
http://dx.doi.org/10.5761/atcs.nm.18-00032
Descripción
Sumario:Purpose: Transcarotid transcatheter aortic valve implantation (TAVI) is one alternative approach if unfavorable femoral access. However, this approach may cause cerebral vascular accidents (CVAs) by temporarily occluding common carotid artery (CCA). The purpose of this study is to develop a new method reducing cerebral ischemia during transcarotid TAVI. Methods: We inserted an 8- and 18-Fr. sheath in CCA with tip toward brain and aortic arch, respectively, and connected their side arms to create a bypass flow. Medtronic CoreValve was then delivered and deployed in position after pre-TAVI balloon dilatation. Results: Three patients received this implantation. There were no CVAs or transient ischemic attacks (TIAs) after the procedure and all patients had been followed up uneventfully for 1 year. Conclusion: Our technique is feasible and potentially reduces stroke in transcarotid TAVI.

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