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TAVI embolisation - Part 2

18 Nov 2025 – From PCR London Valves 2025

This session focuses on managing complications related to TAVI valve embolisation and migration. It includes detailed case discussions on balloon-expandable valve dislocation into the left ventricle, intra-annular migration managed by valve-in-valve techniques, and successful strategies for self-expanding valve migration. The session underscores the importance of readiness...

TAVI: technical tips and tricks

18 Nov 2025 – From PCR London Valves 2025

This session provides practical technical guidance for TAVI procedures emphasizing multimodality imaging for ultra-low contrast implantation, contrast-free techniques tailored for type 0 bicuspid aortic valves, and innovative bailout strategies for rapid pacing failure. It also covers advanced access management approaches in contrast-zero TAVI and current commissural...

Mitral TEER in complex scenarios

18 Nov 2025 – From PCR London Valves 2025

This session presents complex clinical scenarios in mitral transcatheter edge-to-edge repair (TEER), illustrating advanced procedural techniques and multidisciplinary management. Topics include on-circuit aspiration thrombectomy to facilitate TEER, combined interventions addressing multiple valve pathologies, timing considerations in healed mitral endocarditis, and TEER application in end-stage idiopathic cardiomyopathy....

Complications of mitral TEER

18 Nov 2025 – From PCR London Valves 2025

This session addresses complications associated with mitral transcatheter edge-to-edge repair (TEER), showcasing innovative bailout methods such as snare-assisted retrieval of undeployed devices, managing leaflet perforations with latest-generation devices, cases of valve-adjacent tears, mechanical support considerations when pumps fail, and the clinical impact of iatrogenic fossa ovalis...

TAVI: nightmare in the cathlab - Part 3

18 Nov 2025 – From PCR London Valves 2025

This session reviews challenging complications encountered during TAVI procedures, highlighting emergent situations such as coronary occlusion and cardiac arrest. It also discusses unique cases including bicuspid aortic valve-related haemolysis, novel vascular access approaches like lithotripsy, and successful management of double perforation complications. The session provides critical...

TAVI-in-TAVI - Part 2

18 Nov 2025 – From PCR London Valves 2025

This session explores the evolving field of TAVI-in-TAVI interventions, presenting complex cases such as transfemoral TAVI-in-TAVI for degenerated transapical clip-fixed valves in transplanted hearts, management of very late TAVI migration in Bentall de Bono patients, TAVI for degenerated Evolut R valves, stepwise approaches to coronary protection...

TAVI complications - Part 5

18 Nov 2025 – From PCR London Valves 2025

This session highlights acute and urgent complications following TAVI implantation, including myocardial infarction, cardiac arrest, and challenging catheterization scenarios. It provides detailed case analyses illustrating the limits of TAVI procedures and the critical importance of prompt recognition and intervention in adverse events, enhancing clinician preparedness for...

Curious TAVI scenarios - Part 3

18 Nov 2025 – From PCR London Valves 2025

This session examines unusual and challenging clinical scenarios following TAVI, including presentations of cyanosis, evolving valvular defects such as growing paravalvular holes, atypical imaging findings, paradoxical transvalvular gradients switching from aortic regurgitation to stenosis resolved by postdilatation, and bicoronary protection techniques in patients with low coronary...

Angiography-based quantitative flow reserve in coronary vasospastic angina

03 Jun 2020

A 60-year-old woman with a history of cardiac arrest associated with MINOCA (myocardial infarction with no coronary artery disease) event in the territory of the left main artery, underwent coronary angiography for recurrent episodes of chest pain leading to 4 hospitalizations in the last 2 years...

Image in cardiology: QFR in vasospastic angina

When transfemoral TAVI is not an option: rethinking alternative access strategies

18 Jun 2026

In this article, Ulrich Schäfer explores the evolving landscape of access strategies in transcatheter aortic valve implantation (TAVI). While the transfemoral approach remains the gold standard, a significant proportion of patients are not suitable due to peripheral vascular disease or anatomical constraints.
Drawing on clinical evidence and...

Author

Ulrich Schaefer
Alternative access, if transfemoral is not working

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