A Novel Bailout Snare Technique Sparing Recross the Aortic Valve During Transcatheter Aortic Valve Implantation

Abstract

Transcatheter aortic valve replacement (TAVR) procedure was planned for a 68-year-old female patient diagnosed with severe aortic stenosis by transthoracic echocardiography. The first valve unexpectedly dislodged during catheter tip withdrawal after full deployment. A second valve deployment became necessary, posing challenges due to the difficulty of passing the second valve delivery system through the first valve frame. The snare technique is typically used in cases where there are difficulties in delivering the transcatheter heart valve system across the native aortic valve during the TAVR procedure. We described a novel bailout technique to capture the delivery system in the main access using a snare catheter from the secondary access, while retaining the stiff wire in the left ventricle. This technique could be particularly applicable in scenarios where recrossing is challenging and risky.