Intravascular lithotripsy-assisted balloon angioplasty to facilitate transfemoral transcatheter aortic valve implantation in a patient with coral reef aorta

• Published in: BMJ case reports Vol. 14; no. 3; p. e240876
• Main Authors: Morris, Joseph Patrick, Cadogan, Diarmaid, Casserly, Ivan P
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 23.03.2021; BMJ Publishing Group
• Subjects: Abdomen; Angioplasty; Angioplasty, Balloon; Aorta; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - surgery; Atherosclerosis; Blood pressure; Blood products; Calcification; Cardiac arrhythmia; Cardiovascular disease; Case Report; Case reports; Coral Reefs; Coronary vessels; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Hypertension; Intermittent claudication; Lithotripsy; Patients; Surgeons; Transcatheter Aortic Valve Replacement; Treatment Outcome; Ultrasonic imaging; interventional cardiology; valvular diseases
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-240876

This case describes the management of a woman in her 70s with severe symptomatic aortic stenosis and concomitant severe stenosis of the suprarenal abdominal aorta due to ‘coral reef’ calcification of the aortic wall and lumen (CRA). Due to her religious beliefs as a Jehovah’s Witness regarding the use of blood products, she rejected the option of surgical aortic valve replacement. Transfemoral (TF) delivery of a transcatheter aortic valve was challenged by the presence of CRA. A successful TF transcatheter aortic valve implantation (TAVI) was achieved by the treatment of the CRA with intravascular lithotripsy-assisted angioplasty, followed by delivery and deployment of a self-expanding TAVI valve.