1st time in Asia-Pacific
TAVI through Carotid Artery
(artery in the neck)
Case Report:
Background:
69 yr Female, diabetic, hypertensive, stroke history, renal issues, allergic to blood transfusion, allergic to several medicines – presented with breathlessness, chest pain, black-outs. She was diagnosed with severe aortic stenosis.
Upon CT analysis, she was found unsuitable for trans-femoral TAVI access due to:
– Stent implanted in right femoral
– Vascular graft on left ilio-femoral
Planning:
With all 4 access sites unfavourable, trans-carotid (TC) approach was decided with surgical access to left carotid route for TAVI.
CT angio of brain was done to document adequate blood supply to brain through circle of willis.
Procedure:
Acurate neo 2TM (AN2) small (23mm) was implanted after pre-dilatation with 18mm NC balloon. Procedure was successful with zero leak and single digit gradient. No post-dilatation was required. Supra-annular AN2 gave better EOA and patient went home with significant improvement in her daily activities.
iSleeve introducer sheath and the AN2 delivery system were stable & performed remarkably well in trans-carotid approach and presented no challenges or additional maneuvering for usage.