PMID- 37181472
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230516
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 7
IP  - 5
DP  - 2023 May
TI  - Combined approach of carotid endarteriectomy and transcarotid transcatheter 
      aortic valve implantation as a minimally invasive one-step treatment of aortic 
      stenosis: a case report.
PG  - ytad184
LID - 10.1093/ehjcr/ytad184 [doi]
LID - ytad184
AB  - BACKGROUND: Despite the gold-standard approach for transaortic valve implantation 
      (TAVI) remains transfemoral (TF), alternative approaches are needed in patients 
      who present contraindications to transfemoral access. CASE SUMMARY: We report the 
      case of a 79-year-old female with a symptomatic high-gradient severe aortic 
      stenosis-mean gradient of 43 mmHg-and a significant supra-aortic trunk stenosis 
      (left carotid artery: 90-99%; right carotid artery: 50-70%), and who was 
      hospitalized for progressive dyspnoea New York Heart Association (NYHA) stage 
      III. In this high-risk patient, it was decided to perform a TAVI. Because of a 
      history of stenting of both common iliac arteries in a context of an arterial 
      insufficiency of the lower limbs (Leriche classification stage III) and stenotic 
      thoraco-abdominal aorta atheromatosis, an alternative approach to the 
      transfemoral transaortic valve implantation (TF-TAVI) one was needed. It was 
      decided to perform a combined transcarotid-TAVI (TC-TAVI) with EDWARDS S3 23 mm 
      valve with a left endarteriectomy during the same operating time. DISCUSSION: Our 
      case illustrates an alternative approach to perform a percutaneous aortic valve 
      implantation, despite supra-aortic trunk stenosis, in a high-risk surgical 
      patient contraindicated to a TF-TAVI. Transcarotid transaortic valve implantation 
      remains a safe alternative when TF-TAVI is contraindicated, and the combined 
      approach of carotid endarteriectomy and TC-TAVI offers a minimally invasive 
      one-step treatment in high operative risk patients.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Bourlond, Baudouin
AU  - Bourlond B
AUID- ORCID: 0000-0002-9340-2521
AD  - Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 
      1011 Lausanne, Switzerland.
FAU - Dulguerov, Filip
AU  - Dulguerov F
AD  - Department of Cardiac Surgery, Lausanne University Hospital (CHUV), Rue du Bugnon 
      46, 1011 Lausanne, Switzerland.
FAU - Longchamp, Justine
AU  - Longchamp J
AD  - Department of Vascular Surgery, Lausanne University Hospital (CHUV), Rue du 
      Bugnon 46, 1011 Lausanne, Switzerland.
FAU - Kirsch, Matthias
AU  - Kirsch M
AUID- ORCID: 0000-0002-9213-7578
AD  - Department of Cardiac Surgery, Lausanne University Hospital (CHUV), Rue du Bugnon 
      46, 1011 Lausanne, Switzerland.
LA  - eng
PT  - Case Reports
DEP - 20230503
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC10171836
OTO - NOTNLM
OT  - Aortic stenosis
OT  - Case report
OT  - Minimally invasive
OT  - TAVI
OT  - TAVR
OT  - Transcarotid-TAVI
COIS- Conflict of interest: None declared.
EDAT- 2023/05/14 19:13
MHDA- 2023/05/14 19:14
PMCR- 2023/05/03
CRDT- 2023/05/14 12:19
PHST- 2022/07/05 00:00 [received]
PHST- 2022/09/05 00:00 [revised]
PHST- 2023/04/12 00:00 [accepted]
PHST- 2023/05/14 19:14 [medline]
PHST- 2023/05/14 19:13 [pubmed]
PHST- 2023/05/14 12:19 [entrez]
PHST- 2023/05/03 00:00 [pmc-release]
AID - ytad184 [pii]
AID - 10.1093/ehjcr/ytad184 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2023 May 3;7(5):ytad184. doi: 10.1093/ehjcr/ytad184. 
      eCollection 2023 May.