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Updated: May 2, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Carotid-access transcatheter aortic valve replacement in a patient with a previous mitral valve replacement
Michael J Daly1, Paul H Blair, Thomas Modine
1The Heart Centre, Royal Victoria Hospital, Belfast, United Kingdom.
Insights
Transcatheter aortic valve replacement (TAVR) was successfully performed via carotid artery access under regional anesthesia. This approach is suitable for complex patients with rheumatic heart disease and prior valve surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Rheumatic heart disease poses challenges for cardiac procedures.
- Previous mitral valve replacement increases complexity in aortic valve interventions.
- Managing patients with multiple comorbidities requires tailored strategies.
Abstract:
We describe a case of transcatheter aortic valve replacement (TAVR) using carotid artery access and regional anesthesia in a patient with rheumatic heart disease, previous mitral valve replacement, and multiple co-morbidities. It highlights the role of the multidisciplinary Heart Team and multimodality imaging in reaching and implementing an appropriate management plan in this complex patient group.
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