Abstract
An 84-year-old woman with aortic stenosis underwent antegrade balloon aortic valvuloplasty (BAV). After transseptal puncture, we introduced a 7-Fr wedge catheter into the left ventricle and across the aortic valve. We then inserted a 0.032-inch soft guide wire, and the tip of the guide wire was advanced into the brachial artery and exchanged for a stiff guide wire. We externalized the tip of the stiff guide wire from the radial artery. Finally, we advanced an Inoue balloon (Toray, Tokyo, Japan) across the aortic valve and inflated the balloon. Transradial externalization makes antegrade BAV an even less invasive procedure.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Orzalkiewicz M, Rana B, Rekhraj S, Shapiro L, Densem C. Balloon aortic valvuloplasty in the Tavr ERA—single tertiary centre experience. Heart. 2014;100(Suppl 3):A47–8.
Eltchaninoff H, Durand E, Borz B, Furuta A, Bejar K, Canville A, et al. Balloon aortic valvuloplasty in the era of transcatheter aortic valve replacement: acute and long-term outcomes. Am Heart J. 2014;167(2):235–40.
Saia F, Marrozzini C, Ciuca C, Guastaroba P, Taglieri N, Palmerini T, et al. Emerging indications, in-hospital and long-term outcome of balloon aortic valvuloplasty in the transcatheter aortic valve implantation era. EuroIntervention. 2013;8(12):1388–97.
Sakata Y, Syed Z, Salinger MH, Feldman T. Percutaneous balloon aortic valvuloplasty: antegrade transseptal vs. conventional retrograde transarterial approach. Catheter Cardiovasc Interv. 2005;64(3):314–21.
Eisenhauer AC, Hadjipetrou P, Piemonte TC. Balloon aortic valvuloplasty revisited: the role of the Inoue balloon and transseptal antegrade approach. Catheter Cardiovasc Interv. 2000;50(4):484–91.
Krishnan MN, Syamkumar MD, Sajeev CG, Venugopal K, Johnson F, Vinaykumar D, et al. Snare-assisted anterograde balloon mitral and aortic valvotomy using Inoue balloon catheter. Int J Cardiol. 2007;114(1):e9–11.
Lancellotti P, Magne J, Donal E, Davin L, O’Connor K, Rosca M, et al. Clinical outcome in asymptomatic severe aortic stenosis: insights from the new proposed aortic stenosis grading classification. J Am Coll Cardiol. 2012;59(3):235–43.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22):e57–185.
Mohr JP, Thompson JL, Lazar RM, Levin B, Sacco RL, Furie KL, Warfarin-Aspirin Recurrent Stroke Study Group, et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med. 2001;345(20):1444–51.
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent
Written informed consent was obtained from the patient for performance of the procedure.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kato, H., Kubota, S., Goto, T. et al. Externalization of a stiff guide wire via the radial artery: a new technique to facilitate advancement of an Inoue balloon across the aortic valve in patients with aortic stenosis undergoing antegrade balloon aortic valvuloplasty. Cardiovasc Interv and Ther 31, 140–146 (2016). https://doi.org/10.1007/s12928-015-0329-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12928-015-0329-1