Snare-Assisted Valve Positioning of Self-Expanding Valves for Transcatheter Aortic Valve Replacement

Katherine J Kunkel; Paul Fiorilli; Taisei Kobayashi; Nimesh D Desai; Saif Anwaruddin; Howard C Herrmann

doi:10.1016/j.jaccas.2021.02.010

Snare-Assisted Valve Positioning of Self-Expanding Valves for Transcatheter Aortic Valve Replacement

JACC Case Rep. 2021 Mar 31;3(4):658-662. doi: 10.1016/j.jaccas.2021.02.010. eCollection 2021 Apr.

Authors

Katherine J Kunkel¹, Paul Fiorilli², Taisei Kobayashi², Nimesh D Desai³, Saif Anwaruddin², Howard C Herrmann²

Affiliations

¹ Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
² Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

We describe 4 cases in which technical challenges were anticipated in delivering a self-expanding TAVR valve due to challenging aortic anatomy or a previous placed surgical aortic valve. An upfront snare strategy is described which facilitates valve centralization and atraumatic valve delivery. (Level of Difficulty: Advanced.).

Keywords: CT, computed tomography; LVOT, left ventricular outflow tract; NYHA, New York Heart Association; SAVR, surgical aortic valve replacement; STJ, sinotubular junction; STS, Society for Thoracic Surgery; TAVR, transcatheter aortic valve replacement; snare; transcatheter aortic valve replacement (TAVR); valve-in-valve.

Publication types

Case Reports