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A plea for caution: transcatheter aortic valve implantation using the Medtronic CoreValve™ prosthesis without balloon predilatation

EuroIntervention 2013;9:654. DOI: 10.4244/EIJV9I5A105

1. Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany; 2. Department of Anaesthesiology, Klinikum Ludwigshafen, Ludwigshafen, Germany; 3. Central Institute of Radiology and Interventional Radiology, Ludwigshafen
An 87-year-old woman with severe symptomatic aortic stenosis was selected for TAVI by the Heart Team because of a high surgical risk (log. EuroSCORE: 24.2%). The mean transvalvular gradient was 56 mmHg and the diameter of the aortic annulus 21 mm. Therefore a 26 mm CoreValve™ prosthesis (Medtronic, Minneapolis, MN, USA) was selected. We decided to perform the procedure without prior balloon valvuloplasty. After femoral access with an 18 Fr sheath, a stiff guidewire was placed in the left ventricle. The prosthesis was advanced over the stenotic valve without problems (Figure 1A). The sheath cover was then retracted under fluoroscopic guidance and the valve released. ...

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