Transcatheter aortic valve replacement through the carotid artery in a 60-year-old man with aortic stenosis and chronic dialysis: a case report

Abstract

Transcatheter aortic valve replacement (TAVR) through the carotid artery in middle-aged patients with severe aortic stenosis and chronic hemodialysis has been a challenge in clinical practice because of the complex technique. A 60-year-old man was admitted to our hospital because of his symptomatic severe aortic stenosis. With the high risk of open surgery due to chronic hemodialysis, TAVR was selected after an in-depth discussion between the heart team and the patient. The transfemoral access route was not appropriate due to severe calcifications and tortuous iliofemoral arteries, therefore, the left carotid route was chosen. A 29-mm CoreValve Evolut R system was successfully implanted without any complications. His symptoms significantly improved at 12- month follow-up, without any major cardiovascular adverse events. TAVR via the carotid artery thus demonstrates the feasibility, safety, and effectiveness in such complex conditions.