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2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Association of Plaque Location and Vessel Geometry Determined by Coronary Computed Tomographic Angiography With Future Acute Coronary Syndrome–Causing Culprit Lesions Screening for Atrial Fibrillation With ECG: USPSTF Recommendation Subclinical Atherosclerosis Burden by 3D Ultrasound in Mid-Life: The PESA Study Risk Stratification Guided by the Index of Microcirculatory Resistance and Left Ventricular End-Diastolic Pressure in Acute Myocardial Infarction Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study Effect of improved door-to-balloon time on clinical outcomes in patients with ST segment elevation myocardial infarction Robotics in percutaneous cardiovascular interventions A prospective, randomised trial of transapical transcatheter aortic valve implantation vs. surgical aortic valve replacement in operable elderly patients with aortic stenosis: the STACCATO trial Long-Term Outcomes in Women and Men Following Percutaneous Coronary Intervention
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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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