title: Urgent trans-axillary valve-in-valve procedure using the Edwards 16-F expandable introducer.
abstract: Transcatheter aortic valve implantation could represent an alternative option to conventional surgery in high-risk patients with degeneration of aortic bioprosthesis. Herein, we report the performance of a valve-in-valve procedure in urgent conditions and via the left axillary artery in a patient with patent left internal mammary artery coronary graft. A 23-mm Edwards Sapien(®) transcatheter valve was deployed within a 23-mm Edwards Magna Ease bioprosthesis through the novel Edwards 16-F expandable introducer. In this non-elective case, the expandable introducer allowed a safe procedure, reduced the risk of subclavian injury, and preserved the left internal mammary artery graft flow.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Pontchaillou Hospital, Rennes, France.
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
authors.forename: Marc
authors.initials: M
authors.lastname: Bedossa
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Verhoye
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery / Q000000981:diagnostic imaging; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation*; D062906:Cardiac Catheters; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome