Retrograde percutaneous aortic valve implantation for critical aortic stenosis.

摘要: Recently, a prosthetic aortic valve has been implanted percutaneously in several patients using an antegrade transseptal approach. This shown to be feasible and associated with dramatic hemodynamic improvement. We report retrograde implantation of percutaneous heart (PHV) 84-year-old man critical stenosis refractory congestive failure after difficulties encountered initial While attempting PHV, the anterior leaflet mitral was tethered by guidewire resulting severe regurgitation pulseless electrical activity. Cardiac resuscitation successful. Utilizing approach, PHV successfully stable position below coronary ostia well above leaflets. The area increased from 0.55 1.7 cm2 only mild paravalvular regurgitation. Despite marked improvement function, patient died secondary guidewire-induced laceration, regurgitation, cardiogenic shock. Retrograde can performed substantial increase acceptable degree Although approach may greater risk vascular access site complications, it considerably safer avoiding potential injury valve. Further refinements technique establish as preferred means nonsurgical stenosis.