A safe and simple technique for crossing stenotic aortic valves.

To describe and to validate a new technique for crossing stenotic aortic valves (AV). Current techniques for crossing the AV may be time-consuming and hazardous. One hundred consecutive patients with severe aortic stenosis treated by transfemoral TAVI were prospectively selected to have an initial attempt of 5 min to cross the AV with a novel pigtail/J-wire technique before switching to the conventional Amplatz®/straight wire approach. For the pigtail/J-wire technique, the catheter is placed 3-4 cm above the AV and turned anteriorly in the 30° RAO view. A J-wire pushed out of the pigtail-catheter will reach the anterior wall of the ascending aorta, forming a u-shaped curve above the AV. The height of the pigtail catheter determines the width of the curve, rotation will help to find an orientation, where the vertex of the curved J-wire easily passes the AV. We analyzed the primary success rate within 5 min and the mean crossing time required. Patients were 83.5 ± 5.5 years of age and predominantly male (62%). Primary success rate was 86%, AV crossing took 48.2 ± 34.6 s without complications. Fourteen failed cases were successfully managed with AL1- (6) and both, AL1- and AL2-catheters (8), respectively CONCLUSIONS: The pigtail/J-wire technique for AV crossing is safe, simple and fast. Primary placement of a pigtail catheter into the left ventricle at a success rate of 86% facilitates TAVI procedures.

Citation

Wolfgang Schoels, Marwan S Mahmoud, Mathias Kullmer, Mohamad Dia. A safe and simple technique for crossing stenotic aortic valves. Clinical research in cardiology : official journal of the German Cardiac Society. 2021 Mar;110(3):377-381

Mesh Tags

PMID: 32949287

search → result