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Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients Impact of Staging Percutaneous Coronary Intervention in Left Main Artery Disease: Insights From the EXCEL Trial Accuracy of Fractional Flow Reserve Derived From Coronary Angiography 1-Year Outcomes of Delayed Versus Immediate Intervention in Patients With Transient ST-Segment Elevation Myocardial Infarction The contribution of tissue-grouped BMI-associated gene sets to cardiometabolic-disease risk: a Mendelian randomization study Complex PCI procedures: challenges for the interventional cardiologist Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement Dual Antiplatelet Therapy Duration in Medically Managed Acute Coronary Syndrome Patients: Sub-Analysis of the OPT-CAD Study
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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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