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Updated: Jun 8, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
How should I treat a staggering TAVI procedure?
Nicolas M Van Mieghem1, Apostolos Tzikas, Rutger-Jan Nuis
1Department of Cardiology, Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands.
Summary
This study details a successful transcatheter aortic valve implantation (TAVI) in a patient with severe calcified aortic valve stenosis and porcelain aorta. The minimally invasive procedure improved the patient's symptoms of shortness of breath and fatigue.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- A 79-year-old female with chronic myeloid leukemia presented with NYHA class 3 shortness of breath and fatigue.
- The patient exhibited significant comorbidities, including porcelain aorta.
Observation:
- Echocardiography revealed severe calcified aortic valve stenosis.
- Multislice computed tomography confirmed porcelain aorta, indicating extensive aortic calcification.
- Logistic EuroSCORE was calculated at 10.3, suggesting intermediate surgical risk.
Findings:
- Transcatheter aortic valve implantation (TAVI) was performed using a Medtronic-CoreValve system via a right transfemoral arterial approach.
- The procedure addressed severe aortic stenosis and porcelain aorta in a high-risk patient.
Implications:
- TAVI offers a viable treatment option for severe aortic stenosis in patients with porcelain aorta.
- Minimally invasive approaches like TAVI can improve outcomes and quality of life in elderly patients with complex cardiovascular conditions.
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