title: Antegrade approach for TAVR with total occlusion of the descending aorta.
abstract: The antegrade approach for aortic valve interventions is well known but has not been widely used for transcatheter aortic valve replacement (TAVR) procedures. We encountered a patient with no possibility of retrograde access due to a totally occluded abdominal aorta who had a failed attempt at apical TAVR. We describe antegrade TAVR despite occlusion of the abdominal aorta, with the arterial limb of the requisite veno-arterial loop created using bilateral arm access, a novel version of the previously described antegrade approach.
authors.affiliation: NorthShore University HealthSystem, Evanston Hospital, Evanston, Illinois.
authors.forename: Justin P
authors.initials: JP
authors.lastname: Levisay
authors.forename: Michael H
authors.initials: MH
authors.lastname: Salinger
authors.forename: Ted
authors.initials: T
authors.lastname: Feldman
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: TAVR; aortic stenosis; aortic valve replacement; transseptal approach