AUTHOR=Medda Massimo , Casilli Francesco , Bande Marta , Tespili Maurizio , Donatelli Francesco 

TITLE=Case report of snaring-assisted TAVR under cerebral embolic protection: the “Chaperone” with “Top Hat” technique

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1213817

DOI=10.3389/fcvm.2023.1213817

ISSN=2297-055X

ABSTRACT=<p>Symptomatic severe aortic stenosis (AS) in patients with intermediate-to-high surgical risk is currently being treated with transcatheter aortic valve replacement (TAVR). We present a case of a TAVR in a severe calcific AS with porcelain aorta and ‘gothic’ aortic arch. Pre-operative thoraco-abdominal computed tomography angiography showed also severe calcification at the sinotubular junction with protruding huge calcified nodules extending in ascending aorta and multiple calcific stenosis of both iliac-femoral vessels, severely tortuous. The choice of the interventional access was not easy and the high risk of an acute intra-procedural brain event guided the procedural planning. To our knowledge, this is the first case of TAVR with complete cerebral protection with Triguard system device and ‘snaring-assisted’ valve advancement.</p>