EuroIntervention Journal: imaging for TAVI
Watch the short imaging video on TAVI from "How should I treat an unexpected deadlock at the time of transcatheter aortic valve prosthesis implantation?"
Over the years, transfemoral TAVI has progressively evolved, and complication rates have markedly decreased with continuously adjusted technological improvements and procedural refinements. However, although TAVI is now performed in a straightforward, standardised fashion, the procedure remains complex, especially if unanticipated events occur.
One fundamental principle of a standardised transfemoral TAVI procedure is the safe placement of an atraumatically shaped, long, stiff guidewire in the left ventricular apex. Once precisely positioned, the location of this guidewire needs to be carefully observed in order to prevent ventricular perforation by uncontrolled forward movement or accidental dislodgement into the ascending aorta.
Dall’Ara et al describe the dislodgement of the guidewire during alignment of the balloon-expandable Edwards SAPIEN 3 prosthesis resulting in a “deadlock” of the valve and delivery system.