title: Management of acute left main obstruction after transcatheter aortic valve replacement: the "tunnel technique".
abstract: Two cases of acute left main (LM) obstruction complicating transcatheter aortic valve replacement (TAVR) and their management are reported. TAVR with a self-expandable transcatheter aortic prosthesis was performed for treating severe aortic stenosis with small aortic root and severe aortic regurgitation of a degenerated stentless bioprosthesis, respectively. Left main coronary obstruction occurred at a different time from the index procedure. A novel stent-based angioplasty treatment, denominated "the tunnel technique," was successfully applied in both cases and herein described.
authors.affiliation: Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili Hospital, Brescia, Italy. clafiorina@yahoo.it
authors.forename: Claudia
authors.initials: C
authors.lastname: Fiorina
authors.forename: Salvatore
authors.initials: S
authors.lastname: Curello
authors.forename: Diego
authors.initials: D
authors.lastname: Maffeo
authors.forename: Roberto
authors.initials: R
authors.lastname: Lorusso
authors.forename: Giuliano
authors.initials: G
authors.lastname: Chizzola
authors.forename: Federica
authors.initials: F
authors.lastname: Ettori
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional