Video : TAVI in functionally bicuspid aortic valve with heavy calcification

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Cardiology / Valvular / Aortic / Case in the box

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AS treatment has known a revolution since the introduction of TAVI. Now indications expand from critical AS to more complex such aortic disease as bicuspid and AR. The Lotus edge technology known as mechanical expandable TAVR device offer a unique treatment to complex aortic stenosis patients.

Educational objectives

Know how to treat a bicuspid aortic valve with a Lotus edge TAVI device
Know how to select the size of the lotus valve
Know how to implant a Lotus edge step by step
Understand the potential advantages of the Lotus devices in bicuspid AS

Step-by-step procedure: supra-articular femoropopliteal percutaneous bypass

1) Planning the procedure using CT

2) Getting femoral access

3) Sheath advancement

4) Sentinel device positioning

5) Safari positioning and predilatation

6) Lotus deployment

7) Control of lotus deployment

8) closing of access site

Bibliography

1. 1. Armario X, Rosseel L, Kharbanda R, Khogali S, Abdel-Wahab M, Van Mieghem NM, Tchétché D, Dumonteil N, De Backer O, Cotton J, McGrath B, Balakrishnan D, Ali N, Farhan S, Joseph J, Charbonnier G, Okuno T, McHugh F, Hildick-Smith D, Gilgen N, Hokken T, Spence MS, Frerker C, Angelillis M, Grygier M, Cockburn J, Bjursten H, Jeger RV, Teles R, Petronio AS, Pilgrim T, Sinning JM, Nickenig G, Søndergaard L, Blackman DJ, Mylotte D.JACC Cardiovasc Interv. 2021 Jan 25;14(2):172-181. doi: 10.1016/j.jcin.2020.09.044. Epub 2020 Nov 25.PMID: 3347863

2. 2. Solomonica A, Choudhury T, Bagur R.Expert Rev Med Devices. 2018 Nov;15(11):763-769. doi: 10.1080/17434440.2018.1536543. Epub 2018 Oct 22.

Protocol

Procedure time: 50 min
Exposure time:18 min
Exposure: 892 mGy
Contraste volume:190 ml iomeron

Shooting date : 2019-10-18
Last update : 2021-07-08

Join the Discussion

Shafiq K. Great case !!!
Very well executed !!
Beautifully explained step by step.
Amazing, no use of Ultrasound for groin access.
I love the contra-lateral angio for access site for the main sheath.
Khalid Shafiq, MD, FACC, FSCAI.
Paris, Texas, USA.

2021-07-10, 18h10
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ashok D. Great case.. excellent demonstration.. congratulations to whole team.. waiting ✋for next case to enjoy..
Thanks for sharing

2021-07-16, 5h39
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TAVI in functionally bicuspid aortic valve with heavy calcification

Case of the month: July 2021

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