Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Implantation

Abstract

During the last decade, transcatheter aortic valve implantation (TAVI) has evolved as a well-established therapy for aging patients suffering from symptomatic severe aortic valve stenosis. This is also reflected in the recently updated international guidelines on managing patients with valvular heart disease. A transfemoral (TF) TAVI approach has proven superior to alternative access strategies. With the introduction of intravascular lithotripsy (IVL), patients with calcified iliofemoral vascular disease and borderline intraluminal diameters have also become candidates for percutaneous TF-TAVI. Moreover, IVL reduces the risk of major vascular complications by modifying the superficial and deep vascular calcium, thereby changing the vessel compliance and controlling luminal expansion. In this way, IVL has shown to safely facilitate TF delivery of TAVI devices in patients with calcified peripheral artery disease. The present article aims to provide a detailed step-by-step description on how to perform IVL-assisted TF-TAVI safely and efficiently. Furthermore, a literature review on the outcomes obtained with this technology is included, along with a concise discussion on this unique TAVI approach.

Original languageEnglish
Article numbere63556
JournalJournal of visualized experiments : JoVE
Volume181
Number of pages12
ISSN1940-087X
DOIs
Publication statusPublished - 9 Mar 2022

Keywords

  • Aortic Valve/surgery
  • Aortic Valve Stenosis/surgery
  • Femoral Artery/surgery
  • Humans
  • Lithotripsy
  • Transcatheter Aortic Valve Replacement/adverse effects
  • Treatment Outcome

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