Trans-Subclavian Artery Combined With Artificial Graft Technique for Severe Calcific Aortic Stenosis With Tortuous Anatomy.

OBJECTIVES

The study sought to describe a hybrid trans-subclavian-artificial graft technique for transcatheter aortic valve replacement in patients with severe calcific aortic stenosis, vascular tortuosity, and anatomical constraints.

KEY STEPS: Preprocedural planning and access selection; graft anastomosis and access stabilization; wire crossing and balloon predilation; coronary protection and valve deployment; postprocedural outcomes.

POTENTIAL PITFALLS: Graft instability leading to system migration; coronary occlusion risk; hemodynamic instability.

TAKE-HOME MESSAGE: Hybrid left subclavian artery-graft access enables transcatheter aortic valve replacement in anatomically complex patients; procedural success hinges on meticulous graft stabilization and dynamic imaging.