JACC. Case reports · 2026
4-Dimensional Intracardiac Echocardiography-Guided Antegrade TAVR Using a Novel CABLE-TAVR Technique.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Robin Kaleb J, Campbell Joshua M, Castellanos Jorge A
Аннотация
BACKGROUND: An antegrade approach to transcatheter aortic valve replacement (TAVR) has become less common because of the complexity and chance of complication, but use of a large-bore sheath to protect the mitral valve has been described.
CASE SUMMARY: We present a 75-year-old patient with severe symptomatic aortic stenosis who underwent antegrade TAVR with 4-dimensional intracardiac echocardiography under conscious sedation. We describe a novel technique using an Edwards Commander Delivery System to flex a large-bore sheath across the mitral valve to protect the atrial septum and mitral valve during valve delivery.
DISCUSSION: Patients with limited vascular access for retrograde TAVR and who are not candidates for general anesthesia owing to pulmonary disease can undergo antegrade TAVR under conscious sedation and 4-dimensional intracardiac echocardiography guidance.
TAKE-HOME MESSAGE: Our case illustrates an antegrade approach with a novel technique that may be a suitable alternative to TAVR in high-risk patients who otherwise would not be candidates for aortic valve replacement.
CASE SUMMARY: We present a 75-year-old patient with severe symptomatic aortic stenosis who underwent antegrade TAVR with 4-dimensional intracardiac echocardiography under conscious sedation. We describe a novel technique using an Edwards Commander Delivery System to flex a large-bore sheath across the mitral valve to protect the atrial septum and mitral valve during valve delivery.
DISCUSSION: Patients with limited vascular access for retrograde TAVR and who are not candidates for general anesthesia owing to pulmonary disease can undergo antegrade TAVR under conscious sedation and 4-dimensional intracardiac echocardiography guidance.
TAKE-HOME MESSAGE: Our case illustrates an antegrade approach with a novel technique that may be a suitable alternative to TAVR in high-risk patients who otherwise would not be candidates for aortic valve replacement.