Transcatheter aortic valve implantation via right carotid artery route for severe aortic regurgitation management in a patient with chronic operated type A aortic dissection.

BACKGROUND: Transcatheter aortic valve implantation (TAVI) technique is now widely accepted as an alternative for the treatment of very high-risk patients in cases of aortic stenosis. However, use of this technique in cases of pure native aortic regurgitation (AR) remains discussed. CASE REPORT: We report the case of a 68-year-old patient with severe AR referred to our hospital 10 years after a supracoronary ascending aorta replacement surgery for acute type A aortic dissection. Because of respiratory contraindication to redo sternotomy, we treated this patient with the implantation of a CoreValve prosthesis inserted via right carotid access. We discuss the TAVI strategy in the case of severe AR and the possibility to use alternative vascular access. CONCLUSION: In very high-risk patients, TAVI can be discussed and considered as an alternative treatment for severe AR, with right carotid access proven as feasible.

Duke Scholars

Author Neil Kenton Stafford Medicine, General Internal Medicine