Preimplantation of protective guide wire during transcatheter aortic valve replacement for patients with high coronary risk: A report of two cases and literature review

Abstract

Objective To investigate the clinical value of preimplantation of protective guide wire during transcatheter aortic valve replacement (TAVR) for patients with high coronary risk. Methods Clinical data were collected from two patients with high coronary risk who received the preimplantation of protective guide wire during TAVR in Department of Cardiac Surgery in our hospital in 2021, and a retrospective analysis was performed for their perioperative clinical data. Results Both patients underwent a successful TAVR surgery, among whom one patient had a coronary stent implanted in the left coronary artery, and the other patient only received pre-protection with coronary guide wire and stent, which were removed after surgery. Postoperative angiography showed that both patients had good opening of the artificial interventional valve, mild regurgitation, and coronary artery patency, with varying degrees of alleviation or disappearance of heart failure symptoms after surgery. After 3 months of postoperative follow-up, echocardiography of the two patients showed normal function of the artificial biological valve of the aortic valve, with slight perivalvular regurgitation, and coronary CT angiography showed no obvious abnormality in the coronary artery. Conclusion The technique of protective wire preimplantation is safe and effective in preventing coronary artery occlusion during TAVR.

Keywords

• radiology, interventiona|transcatheter aortic valve replacement|coronary occlusion|stents|case reports