# Transcatheter aortic valve replacement via direct aortic access for severe aortic stenosis with double aortic arch

## TL;DR

This paper describes a successful TAVR procedure in an elderly patient with a rare aortic condition using a direct aortic access approach.

## Contribution

The study presents a novel case of TAVR via direct aortic access in a patient with a double aortic arch.

## Key findings

- TAVR via direct aortic access is feasible in patients with double aortic arch.
- The procedure was successfully performed in an 85-year-old female with no major complications.
- This case highlights the importance of individualized access route planning in complex anatomical scenarios.

## Abstract

Transcatheter aortic valve replacement (TAVR) is an established treatment for managing severe aortic stenosis. Preoperative planning requires cautious identification of the access route, which can be challenging in patients with anatomical abnormalities of the aorta. Double aortic arch (DAA) is a congenital condition where the aorta bifurcates into two separate vessels that encircle the trachea and esophagus, thereby forming a vascular ring. This condition accounts for ~1% of congenital cardiovascular anomalies. Previous reports on TAVR performed on patients with DAA are limited, and there is no consensus on the appropriate access route. Herein, we present an 85-year-old female patient with DAA and aortic stenosis who underwent a successful TAVR using the direct aortic approach.