title: Critical aortic stenosis and acute ascending aortic penetrating ulcer managed utilizing transapical TAVR and TEVAR.
abstract: Thoracic endovascular aortic repair (TEVAR) of acute ascending aortic pathology is feasible; however, the unique features of this aortic segment in addition to access challenges restricts its use to a select, high-risk subset of patients. With the advent of TAVR, large device delivery using transapical access has become a well-defined technique. We report a patient with critical aortic stenosis and an acute ascending aortic penetrating ulcer with tamponade managed successfully utilizing transapical TAVR and TEVAR. To our knowledge, this is the first reported case of a hybrid single-stage TAVR and ascending aortic TEVAR using transapical access.
authors: Department of Cardiothoracic Surgery, St. Luke's Mid America Heart Institute, Kansas City, Missouri.
authors: Keith B
authors: KB
authors: Allen
authors: Department of Cardiothoracic Surgery, St. Luke's Mid America Heart Institute, Kansas City, Missouri.
authors: J Russell
authors: JR
authors: Davis
authors: Department of Cardiology, St. Luke's Mid America Heart Institute, Kansas City, Missouri.
authors: David J
authors: DJ
authors: Cohen
mesh_terms: D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000601:surgery; D003131:Combined Modality Therapy; D016638:Critical Illness; D017548:Echocardiography, Transesophageal / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed / Q000379:methods; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: ascending aorta; endovascular; transcatheter valve