Abstract

When it pops-out: Restart all over again from the beginning?

Author(s): Takehiro Yamashita*, Naoki Iwakiri, Eigo Kurebayashi, Masato Suzuki, Yohei Ohkawa

An 82-year-old female with a severe aortic stenosis (AS) and a history of acute decompensated heart failure was scheduled for TAVR. A stiff wire accidentally dislodged from the left ventricle before delivering an S3 valve to the aortic valve plane. A successful S3 implantation was achieved by crossing a regular wire using the flex wheel of the delivery system handle to align the nose cone with the aortic orifice followed by an exchange to a stiff wire. This is the very first clinical case report of this technique for a possible bailout procedure during a premature LV guidewire dislodgement, which significantly reduces additional risk, procedural time and cost.