title: How should I treat severe symptomatic aortic stenosis with transcatheter aortic valve implantation in a patient with right aortic arch?
abstract: BACKGROUND
  An 84-year-old man suffering from dyspnoea on mild exertion and a 10-year history of mitral valve replacement with a mechanical prosthesis presented to our department. The patient had an isolated right aortic arch.
  
  
  METHODS
  Transthoracic echocardiography demonstrated severe LV systolic dysfunction (EF 25%), good function of the previously implanted mechanical prosthesis and severe aortic stenosis. Multislice computed tomography confirmed the presence of an isolated right aortic arch with mirror-image branching.
  
  
  METHODS
  Severe symptomatic aortic stenosis in a patient with right aortic arch at high risk for surgical reintervention.
  
  
  RESULTS
  Transcatheter aortic valve implantation using conventional delivery system.
authors.affiliation: Department of Cardiovascular Diseases, Le Scotte University Hospital, University of Siena, Siena, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: D'Ascenzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Iadanza
authors.forename: Valerio
authors.initials: V
authors.lastname: Zacà
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sinicropi
authors.forename: Andrea
authors.initials: A
authors.lastname: Torrisi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sorropago
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
authors.forename: Carlo
authors.initials: C
authors.lastname: Pierli
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Mauro
authors.initials: M
authors.lastname: De Benedictis
authors.forename: Innocenzo
authors.initials: I
authors.lastname: Scrocca
authors.forename: Jan
authors.initials: J
authors.lastname: Kovac
authors.forename: Julia
authors.initials: J
authors.lastname: Baron
authors.forename: Derek T
authors.initials: DT
authors.lastname: Chin
mesh_terms: D000369:Aged, 80 and over; D000792:Angiography; D001013:Aorta, Thoracic / Q000002:abnormalities*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*