First Transcatheter Aortic Valve Implantation via Carotid Artery Performed in Japan.

Transcatheter aortic valve implantation (TAVI) through a peripheral arterial access is often complicated by concomitant arteriopathy. We describe here the first successful case of TAVI through the carotid artery in Japan. The patient was an 83-year-old woman with severe aortic stenosis (AS). Preoperative computed tomography (CT) revealed a shaggy distal aortic arch and left subclavian artery ostium, along with severely calcified bilateral iliofemoral arteries. Trans-apical and direct aortic approaches were abandoned because of frailty. Following the thorough cerebrovascular assessment, the left common carotid artery was selected for arterial access and a CoreValve transcatheter aortic valve was successfully implanted without neurologic complications.