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Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Bioprosthetic valve oversizing is associated with increased risk of valve thrombosis following TAVR 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Transcatheter Aortic Valve Replacement vs Surgical Replacement in Patients With Pure Aortic Insufficiency The Utility of Rapid Atrial Pacing Immediately Post-TAVR to Predict the Need for Pacemaker Implantation Prognostic implications of baseline 6‐min walk test performance in intermediate risk patients undergoing transcatheter aortic valve replacement Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week From organic and inorganic phosphates to valvular and vascular calcifications Cardiac Structural Changes After Transcatheter Aortic Valve Replacement: Systematic Review and Meta-Analysis of Cardiovascular Magnetic Resonance Studies
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Clinical Case Study2020 Nov 14;ehaa817.

JOURNAL：Eur Heart J. Article Link

Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion

A Dibie, Q Landolff, A Veugeois et al. Keywords: clinical case; chimney technique; TAVR-in-TAVR procedure; left main artery ostium occlusion

ABSTRACT

An 87-year-old woman was referred to our centre for a valve-in-valve transcatheter aortic valve replacement (TAVR). She underwent a TAVR procedure with implantation of a SAPIEN XT 26 mm (Edwards Lifesciences) bioprosthesis 7 years before but subsequently developed symptomatic aortic valve failure (mean gradient = 64 mmHg).

Pre-procedural computed tomography (CT) scan identified a low height between the valvular plane and left main coronary artery (LMA) ostium equal to 2.7 mm (Panel A1). Valve simulation technique was applied: the virtual transcatheter heart valve/coronary distance was measured at 4.0 mm (Panel A2). The coronary angiography revealed no recurrent stenosis (Panel B)....

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