TAVI in small annulus - LIVE case

A 79-year-old female with CAD (stenosis in the mid-LAD), asthma, and diabetes presented with symptomatic severe aortic stenosis. Left ventricular function was preserved, with an annulus measuring 355 mm², and the valves were heavily calcified.

A Navitor Vision valve was implanted with predilatation (18 mm balloon) under Acunav 4D ICE guidance through right femoral venous access. Right femoral access was used for the procedure, while a temporary pacemaker was placed via left femoral venous access. The right femoral access was closed using a ProGlide.

LIVE Educational Case from Keio University Hospital - Tokyo, Japan

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Key moments

• 6:34-8:21 - CT analysis
• 42:50-59:41 - Valve implantation
• 1:00:00-1:02:19 - ICE 4D analysis
• 1:03:40-1:04:40 - Procedural analysis
• 1:06:04-1:07:41 - Femoral closure

Keywords: TAVI, Navitor vision, ICE 4D, Femoral closure, small aortic annulus