First trans-subclavian transcatheter aortic valve replacement using Lotus valve system

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Severe aortic stenosis (AS) often requires aortic valve replacement.
• Transcatheter aortic valve implantation (TAVI) is a less invasive alternative for high-risk patients.
• Severe iliofemoral arteriopathy precludes standard transfemoral TAVI in about one-third of patients.

Observation:

• A 74-year-old male presented with severe AS and bilateral iliofemoral arteriopathy.
• The patient was not a candidate for the standard transfemoral TAVI approach.

Findings:

• The patient underwent a successful left trans-subclavian (TS) TAVI procedure.
• The Lotus valve system was utilized for the trans-subclavian TAVI.

Implications:

• The left trans-subclavian approach provides a viable alternative TAVI route for patients with contraindications to transfemoral access.
• This case highlights the adaptability of TAVI in complex vascular anatomies.
• Expanding TAVI accessibility for patients with severe AS and challenging iliofemoral disease.