Annals of Thoracic and Cardiovascular Surgery
Online ISSN : 2186-1005
Print ISSN : 1341-1098
ISSN-L : 1341-1098

This article has now been updated. Please use the final version.

Increase Carotid Flow by Double Sheath Connection Technique to Reduce Cerebral Ischemia for Transcatheter Aortic Valve Implantation through Transcarotid Approach
Richard TsaiI-Ming ChenPo-Lin ChenHsin-Bang LeuYing-Hwa ChenHsiao-Huang Chang
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JOURNAL OPEN ACCESS Advance online publication

Article ID: nm.18-00032

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Abstract

Purpose: Transcarotid transcatheter aortic valve implantation (TAVI) is one alternative approach if unfavorable femoral access. However, this approach may cause cerebral vascular accidents (CVAs) by temporarily occluding common carotid artery (CCA). The purpose of this study is to develop a new method reducing cerebral ischemia during transcarotid TAVI.

Methods: We inserted an 8- and 18-Fr. sheath in CCA with tip toward brain and aortic arch, respectively, and connected their side arms to create a bypass flow. Medtronic CoreValve was then delivered and deployed in position after pre-TAVI balloon dilatation.

Results: Three patients received this implantation. There were no CVAs or transient ischemic attacks (TIAs) after the procedure and all patients had been followed up uneventfully for 1 year.

Conclusion: Our technique is feasible and potentially reduces stroke in transcarotid TAVI.

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© 2018 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

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