, Volume 98, Issue 3, pp 201-204
Date: 13 Feb 2009

Implantation of the CoreValve self-expanding valve prosthesis via a subclavian artery approach: a case report

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Sirs: Percutaneous aortic valve replacement (PAVR) is an alternative technique for treatment of aortic stenosis in patients with an excessive surgical risk [8]. In 2002, Cribier and coworkers [2] performed the first in man implantation of a bovine pericardial prosthesis in a 57-year-old man with calcified aortic stenosis and cardiogenic shock, using an antegrade transseptal approach. Recently, they summarized their experience in a small series of patients [3]. Of the 36 patients taken to the catheterization laboratory, 27 patients underwent successfully aortic valve implantation [3]. In 23 cases, Cribier’s group used an antegrade, transseptal approach, in four patients a retrograde approach. Although not specifically emphasized by the authors, the differences in their methods are relevant. The antegrade approach demands a transseptal puncture, and the stiff guiding wire that loops from the left atrium to the ascending aorta may cause severe intraprocedural mitral regurgitation. Webb an ...