Femoro-Femoral Bypass for a Vascular Complication During Transfemoral Aortic Valve Implantation

TL;DR

A 94-year-old woman developed a vascular complication during a heart valve procedure, and a femoro-femoral bypass was used to treat the issue.

Contribution

The paper presents femoro-femoral bypass as a viable and less invasive bailout strategy for vascular complications during TAVI in high-risk elderly patients.

Findings

Femoro-femoral bypass successfully treated acute limb ischemia caused by vascular injury during TAVI.

The procedure is less invasive and faster, making it suitable for super-aged or high-risk patients.

Endovascular therapy failed due to vessel occlusion from a frapped intima.

Abstract

A 94-year-old woman underwent transcatheter aortic valve implantation (TAVI) for treatment of severe aortic stenosis (AS). Final angiography showed the right external iliac artery occlusion due to vascular injury related to a large-diameter introducer sheath. Although we performed endovascular therapy, no guidewires could cross the culprit lesion because the intima had frapped and occluded the vessel lumen. Therefore, we performed femoro-femoral bypass for bailout of acute limb ischemia. Femoro-femoral bypass is a less invasive, shorter operation time and therefore a reasonable strategy as an urgent bailout for vascular complications during TAVI in super-aged or higher-risk surgical patients with severe AS.

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