Trans-carotid transcatheter aortic valve replacement in an octogenarian with complex type B aortic dissection and aneurysm-a case report

Abstract We reported an octogenarian with severe aortic valve stenosis (AS), chronic kidney disease (CKD) and heart failure. Due to advanced CKD, we used a 3-dimensional (3D) trans-esophageal echocardiogram (TEE) for sizing the device before transcatheter aortic valve replacement (TAVR). Non-contrast computed tomography found complex aortic dissection involving arch, descending thoracic, and abdominal aorta. TAVR was approached via right carotid artery using a CoreValve. There was no cerebral vascular accident. Renal function was well preserved. In conclusion, trans-carotid TAVR can be performed safely with complex type B aortic dissection. 3D TEE is an alternative sizing solution in advanced CKD.