Fatal ischemic stroke related to nonpermissive peripheral artery access for percutaneous aortic valve replacement
作者： Colin Berry , Raymond Cartier , Raoul Bonan
DOI: 10.1002/CCD.20958
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摘要: This report describes an 85 year-old man who underwent percutaneous aortic valve replacement (PAVR). With a logistic euroSCORE of 37%, the patient had been refused surgical because unacceptably high peri-operative risk. During PAVR procedure, severe resistance was encountered when advancing 21 Fr delivery catheter through left iliac artery despite pre-dilatation with 7 mm balloon. Following this, promptly achieved without difficulty, excellent positioning, no peri-valvular leak and good hemodynamics. However, transesophageal echocardiography revealed mobile echogenic mass within outflow tract ventricle. The retrieved cardiac bioptome manipulated via femoral 9 sheath. A right cerebral ischemic stroke manifested shortly after post-procedure died on fourth post-operative day. Post-mortem findings subclavian occlusion by vascular tissue. highlights imperative for device-specific access screening criteria need to minimize device size in order safely accomplish PAVR. © 2006 Wiley-Liss, Inc.
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