Coronary access techniques following ACURATE neo2 implantation in surgical bioprosthesis

Figure 1. Novel coronary access techniques to bypass the ACURATE neo2 valve frame following ViV-TAVI. The vertical approach, narrow mammary and snake sinus techniques are presented with (from left to right): fluoroscopic images of diagnostic cannulation, percutaneous coronary intervention, internally mounted borescope view and ex vivo modelling. PCI: percutaneous coronary intervention; ViV-TAVI: valve-in-valve transcatheter aortic valve implantation

Coronary access after transcatheter aortic valve implantation (TAVI) procedures can be challenging due to anatomical, procedural or valve-related factors12. This challenge is further augmented during valve-in-valve (ViV) procedures due to the additional presence of transcatheter or surgical valve frames and leaflets3. Dedicated ...