TAV in TAVI with coronary protection - LIVE Case

Watch a LIVE case followed by a recorded case, regarding a 78-year-old female, with a previous TAVI in 2014 (Sapien 3 26) and sarcoidosis, who presented with symptomatic TAVI stenosis. There was a mis-commissural alignment, with the neoskirt plane above the coronary plane. Under general anesthesia, a Sapien 3 Resilia 23 was implanted with coronary protection using guiding, guideliner, and wires in the LAD and RCA. After predilatation, stents were placed in the LAD-LM and RCA, and the left stent was inflated using a chimney technique. Implantation of the RCA stent was not possible, but the final result was excellent.

Recorded case: 85-year-old female, with previous TEER (2 MitraClips: XTW + XT) and permanent AF, presented with symptomatic aortic stenosis and severe tricuspid regurgitation. A Trilogy 25 M valve was implanted under local anesthesia.

LIVE Educational Case from St. Thomas' Hospital - London, UK

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Key moment

• 1:01:05–1:07:29 – Procedural analysis, coronary protection, and chimney technique in left main

Keywords: TAV in TAV, Aortic stenosis, Chimney technique, Sapien 3 resilia, Trilogy 25M, femoral access closure