Transfemoral transcatheter aortic valve replacement in a patient with a history of artificial aortic arch replacement and stent implantation: a case report and strategies for a super-stiff approach.

Yifan Yang, Yunfeng Yan, Jing Yao, Xinmin Liu, Guangyuan Song

Abstract readCase Reports

In one paragraph

Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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5 · Who and what money

Authors and funding

5 authors.

Yifan YangInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

Yunfeng YanInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

Jing YaoInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

Xinmin LiuInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

Guangyuan SongInterventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.ORCID https://orcid.org/0000-0002-7868-6132

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Transfemoral transcatheter aortic valve replacement (TAVR) is challenging in patients with stiff and tortuous anatomy. In the present case, we presented a patient with super-stiff aortic arch (prior history of aortic arch replacement, stent implantation, and anastomotic fistula plugging) and a summary of strategies for managing such stiff approach. Case summary: A 59-year-old man with symptomatic severe aortic stenosis and a super-stiff aortic arch underwent transfemoral TAVR. Techniques including buddy wire, balloon deflection, balloon-assisted tracking, snare assistance, and long sheath use were considered. Balloon-assisted tracking combined with a long sheath ultimately enabled successful TAVR. Supra-annular anchoring was also confirmed in this case. Discussion: For patients with extremely stiff anatomy, multiple techniques may facilitate successful transfemoral TAVR. Furthermore, in bicuspid aortic valve cases, the narrowed supra-annular region can serve as an effective anchoring zone.

Indexed as

Balloon-assisted trackingCase reportSupra-annulus anchoringTranscatheter aortic valve replacementTransfemoral

Identifiers

PMID42311612

DOI10.1093/ehjcr/ytag388

PMCPMC13270482

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