title: Transcatheter aortic valve implantation via right carotid artery route for severe aortic regurgitation management in a patient with chronic operated type A aortic dissection.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) technique is now widely accepted as an alternative for the treatment of very high-risk patients in cases of aortic stenosis. However, use of this technique in cases of pure native aortic regurgitation (AR) remains discussed.
  
  
  METHODS
  We report the case of a 68-year-old patient with severe AR referred to our hospital 10 years after a supracoronary ascending aorta replacement surgery for acute type A aortic dissection. Because of respiratory contraindication to redo sternotomy, we treated this patient with the implantation of a CoreValve prosthesis inserted via right carotid access. We discuss the TAVI strategy in the case of severe AR and the possibility to use alternative vascular access.
  
  
  CONCLUSIONS
  In very high-risk patients, TAVI can be discussed and considered as an alternative treatment for severe AR, with right carotid access proven as feasible.
authors.affiliation: Department of Cardiovascular Surgery, Institut Lorrain du Coeur et des Vaisseaux, Nancy School of Surgery, University of Lorraine, Nancy, France.
authors.forename: Pablo
authors.initials: P
authors.lastname: Maureira
authors.affiliation: Department of Cardiovascular Surgery, Institut Lorrain du Coeur et des Vaisseaux, Nancy School of Surgery, University of Lorraine, Nancy, France.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Medicine, Banner McKee Medical Center, Loveland, Colorado, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Stafford
authors.affiliation: Department of Cardiovascular Surgery, Institut Lorrain du Coeur et des Vaisseaux, Nancy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiore
authors.affiliation: Department of Cardiovascular Surgery, Institut Lorrain du Coeur et des Vaisseaux, Nancy.
authors.forename: Michael
authors.initials: M
authors.lastname: Angioi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D017755:Prosthesis Fitting / Q000379:methods*; D011859:Radiography; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome