The Prophylactic Chimney Snorkel Technique for the Prevention of Acute Coronary Occlusion in High Risk for Coronary Obstruction Transcatheter Aortic Valve Replacement/Implantation Cases

Fetahovic, T.; Hayman, S.; Cox, S.; Cole, C.; Rafter, T.A.; Camuglia, A.

doi:10.1016/j.hlc.2019.04.009

Cited by 21 publications

(12 citation statements)

References 11 publications

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“…It has been also previously reported in limited case reports in prophylactic setting (29, 30). The prophylactic Chimney technique offers a potential predictable stepwise method of coronary protection that may be employed in the highest coronary occlusion risk patients.…”

Section: Chimney Techniquesupporting

confidence: 57%

How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

Valvo

Costa

Barbanti

2019

Front. Cardiovasc. Med.

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Transcatheter aortic valve-in-valve replacement has been recently reported as a less-invasive alternative to re-do surgery in patients with bioprosthetic valve failure. Although procedural success is achieved in the great majority of patients, this therapy is associated with several potential complications, and coronary occlusion is one of the most feared. This is a rare event, but it is associated with an extremely poor prognosis. In this review, the mechanisms, the identification of patients at high risk, the primary prevention strategies, and treatment of coronary occlusion will be discussed.

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Section: Chimney Techniquesupporting

confidence: 57%

How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

Valvo

Costa

Barbanti

2019

Front. Cardiovasc. Med.

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“…If this fails, a surgical procedure is required. In high-risk cases, new prophylactic techniques including chimney snorkel and basilica have been implemented; however, the data regarding them is scarce [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Ostial Right Coronary Artery Occlusion During Valve Deployment of Transcatheter Aortic Valve Replacement Leading to Acute Right Ventricular Failure: A Perfect Storm and Successful Navigation

Joshi

Duvvuri

Barzallo

et al. 2020

Cureus

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“…coronary obstruction in those at high risk of requiring TAVR in SAV. The "chimney snorkel" is one technique whereby the coronary artery is engaged with a guide catheter and guide extender prior to TAVR in SAV (29). The catheter valve system is deployed, followed by stenting the coronary artery and extending the stent above the bioprosthetic valve.…”

Section: Prevention Of Coronary Artery Obstructionmentioning

confidence: 99%

Overcoming the transcatheter aortic valve replacement Achilles heel: coronary re-access

Arshi

Yakubov

Stiver

et al. 2020

Ann Cardiothorac Surg

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Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for the treatment of symptomatic severe aortic stenosis (AS). Coronary artery disease (CAD) is common in patients with severe AS. As the indications for TAVR extend to lower risk patients with longer life expectancy and as CAD is a progressive condition, coronary angiography will become increasingly common in patients who have had a previous TAVR. Coronary artery re-access after TAVR may be challenging but is possible in most cases. Commissural alignment of the prosthesis with the native coronary ostia plays an important role in successful coronary re-access. Coronary artery obstruction is a potentially devastating complication of TAVR, particularly in valve-in-valve procedures. In the present keynote lecture, we review techniques used to mitigate the risk of coronary obstruction, as well as catheter selection and strategies for selective coronary artery engagement for specific transcatheter aortic valve (TAV) bioprostheses.

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The Prophylactic Chimney Snorkel Technique for the Prevention of Acute Coronary Occlusion in High Risk for Coronary Obstruction Transcatheter Aortic Valve Replacement/Implantation Cases

Cited by 21 publications

References 11 publications

How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

Acute Ostial Right Coronary Artery Occlusion During Valve Deployment of Transcatheter Aortic Valve Replacement Leading to Acute Right Ventricular Failure: A Perfect Storm and Successful Navigation

Overcoming the transcatheter aortic valve replacement Achilles heel: coronary re-access

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