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Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a randomized, controlled trial. Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men The Year in Cardiovascular Medicine 2020: Valvular Heart Disease: Discussing the Year in Cardiovascular Medicine for 2020 in the field of valvular heart disease is Professor Helmut Baumgartner and Dr Javier Bermejo. Mark Nicholls reports Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Prognostic implications of baseline 6‐min walk test performance in intermediate risk patients undergoing transcatheter aortic valve replacement
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Clinical Case Study2020 Nov 14;ehaa817.

JOURNAL：Eur Heart J. Article Link

Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion

A Dibie, Q Landolff, A Veugeois et al. Keywords: clinical case; chimney technique; TAVR-in-TAVR procedure; left main artery ostium occlusion

ABSTRACT

An 87-year-old woman was referred to our centre for a valve-in-valve transcatheter aortic valve replacement (TAVR). She underwent a TAVR procedure with implantation of a SAPIEN XT 26 mm (Edwards Lifesciences) bioprosthesis 7 years before but subsequently developed symptomatic aortic valve failure (mean gradient = 64 mmHg).

Pre-procedural computed tomography (CT) scan identified a low height between the valvular plane and left main coronary artery (LMA) ostium equal to 2.7 mm (Panel A1). Valve simulation technique was applied: the virtual transcatheter heart valve/coronary distance was measured at 4.0 mm (Panel A2). The coronary angiography revealed no recurrent stenosis (Panel B)....

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