TAVI Atlas: Procedural concepts

The website section on procedural concepts offers the community a visual perspective on each valve design. Vascular access, crossing the aortic valve, safe stiff guidewire positioning in the left ventricle, optimal projection, balloon pre-dilatation, valve deployment and access closure.

We present step by step implantation of a transcatheter aortic valve through angiography illustrations, phantom model and cartoon animations.

The use of vascular closure devices is widespread and becoming more common, both with operators who perform their process via the femoral approach and those using radial access. Interventionists performing arterial access procedures should be aware of when and how to use them, as well as the advantages and disadvantages of each device, and predicting and treating any complications which may occur. For more information, consult the PCR-EAPCI Textbook on Chapter 5 on Vascular closure or Chapter 32 on TAVI.

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Vascular access

Find out more about access: fluoroscopy guided access, echo-guided access, femoral angiography, straightening femoral trajectory with a stiff guidewire, preclosure...

Crossing the aortic valve

In patients undergoing TAVI, the retrograde crossing of the stenosed aortic valve is a condition sine qua non. The operators can use different catheter/wire combinations for the manoeuvre of crossing the aortic valve.

Safe stiff guidewire positioning in the left ventricle

Consult the safe stiff guidewire positioning in the left ventricle if you want to learn more about the basic technique and corrective manoeuvre.

Optimal projections in TAVI: adjusting and obtaining optimal projection

A baseline aortogram indicates an optimal projection with all three aortic cusps aligned. This step is crucial during TAVI. The optimal projection also is essential for the placement of the device.

Balloon pre-dilatation

In patients with severe calcific aortic stenosis, balloon aortic valvuloplasty (BAV) is routinely performed in order to pre-dilate the stenosed aortic valve prior to transcatheter aortic valve implantation (TAVI). Although pre-dilatation is considered to be essential for the preparation of the valve landing zone, there is no clear evidence to support its clinical value.

Access closure: ProGlide device

Consult the vascular closure devices for access site closure with Abbott Vascular ProGlide.

Learn more about the enhanced efficacy of the ProGlide systems, which may be attributed to inherent design and characteristics of this closure device.