Vd17 Tavi by Trans-Carotid Approach

Abstract

The TAVI-procedure was performed under loco-regional anesthesia by cervical block. The left common carotid artery (CCA) was surgically exposed by low small cervicotomy and a 3 minutes carotid clamping test was realized in order to evaluate patient's neurological status. A 6-Fr sheath was inserted through the left CCA. The aortic stenosis was crossed using a JR4 catheter with a Terumo straight stiff guidewire. The catheter was pushed into the left ventricle and the guidewire exchanged with an Amplatz Super Stiff. The Edwards sheath was inserted through the left CCA and aortic balloon valvuloplasty was performed. The Edwards Sapien3 transcatheter aortic valve was then advanced using Edwards Certitude delivery system across the calcified aortic valve. The prosthesis was deployed under rapid ventricular pacing at 180/min with excellent seating and no paravalvular leak. The delivery catheter and the sheath were removed, the left CCA was closed and the clamp removed after de-airing.