A safe and simple technique for crossing stenotic aortic valves.

Autor: Schoels, Wolfgang, Mahmoud, Marwan S., Kullmer, Mathias, Dia, Mohamad
Zdroj: Clinical Research in Cardiology; Mar2021, Vol. 110 Issue 3, p377-381, 5p
Abstrakt: Objectives: To describe and to validate a new technique for crossing stenotic aortic valves (AV). Background: Current techniques for crossing the AV may be time-consuming and hazardous. Methods: One hundred consecutive patients with severe aortic stenosis treated by transfemoral TAVI were prospectively selected to have an initial attempt of 5 min to cross the AV with a novel pigtail/J-wire technique before switching to the conventional Amplatz®/straight wire approach. For the pigtail/J-wire technique, the catheter is placed 3–4 cm above the AV and turned anteriorly in the 30° RAO view. A J-wire pushed out of the pigtail-catheter will reach the anterior wall of the ascending aorta, forming a u-shaped curve above the AV. The height of the pigtail catheter determines the width of the curve, rotation will help to find an orientation, where the vertex of the curved J-wire easily passes the AV. We analyzed the primary success rate within 5 min and the mean crossing time required. Results: Patients were 83.5 ± 5.5 years of age and predominantly male (62%). Primary success rate was 86%, AV crossing took 48.2 ± 34.6 s without complications. Fourteen failed cases were successfully managed with AL1- (6) and both, AL1- and AL2-catheters (8), respectively Conclusions: The pigtail/J-wire technique for AV crossing is safe, simple and fast. Primary placement of a pigtail catheter into the left ventricle at a success rate of 86% facilitates TAVI procedures. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index