International Journal of Cardiovascular Sciences. 22/jul/2024;37:e20230147.

Snare-Assisted Aortic Valve Crossing for TAVI: A Case Report

Andre Grazina , Bárbara Lacerda Teixeira , Inês Rodrigues , António Fiarresga , Duarte Cacela

DOI: 10.36660/ijcs.20230147

Abstract

In some transcatheter aortic valve implantation (TAVI) procedures, difficulty in crossing the valve delivery system occurs. There are some described anatomical risk factors as extreme angulation, heavy calcification, and bicuspid morphology. A possible reason may be an unfavorable angle of approach because of the outward push by the incoming crimped bioprosthesis and insufficient support/trackability of the extra stiff wire. Several techniques, tips, and tricks have been developed to overcome this problem and avoid procedure failures, such as the “pull-and-push” technique, pre-dilation, buddy wire, balloon cushion, buddy balloon and snare techniques. Here, we report a case of TAVI complicated by the difficulty in crossing the calcified native aortic valve (AV) that was solved with the snare technique without complications.