title: Successful transfemoral aortic Edwards(®) SAPIEN(®) bioprosthesis implantation without using iodinated contrast media in a woman with severe allergy to contrast agent.
abstract: Severe anaphylactoid reaction after the use of iodinated contrast media are rare but can contraindicate the use of contrast agent. It was the case of a 53-year-old woman suffering from symptomatic severe aortic stenosis, recused for cardiac surgery because of deleterious effects of chest-wall irradiation, with porcelain aorta. We decided to implant a 23-mm Edwards(®) SAPIEN(®) transcatheter aortic valve via a femoral route without using any contrast media. The implantation was successful after surgical approach of the femoral artery, transesophageal echocardiography guiding, and localization of native leaflets and coronary trunk with catheters. Immediate and one month post-interventional follow-up was favorable and echocardiography showed a good functioning of the aortic bioprosthesis. Although conventional angiography is the best way to visualize the good positioning of the valve before deployment, our case suggests that, in special situations, transfemoral implantation of an Edwards(®) SAPIEN(®) aortic bioprosthesis is feasible without any contrast injection.
authors.affiliation: CHU de Bordeaux, Department of interventional cardiology, F-33600, Bordeaux, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Leroux
authors.forename: Marina
authors.initials: M
authors.lastname: Dijos
authors.forename: Pierre
authors.initials: P
authors.lastname: Dos Santos
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000517:prevention & control; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000517:prevention & control; D017548:Echocardiography, Transesophageal; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D003287:Contrast Media