{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T22:01:03Z","timestamp":1761948063815,"version":"3.28.0"},"reference-count":11,"publisher":"Texas Heart Institute Journal","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>We describe transcatheter aortic valve implantation in a patient who had severe peripheral artery disease. The patient's vascular condition required additional preliminary peripheral intervention to enable adequate vascular access.<\/jats:p>\n        <jats:p>A 78-year-old man with severe aortic stenosis, substantial comorbidities, and severe heart failure symptoms was referred for aortic valve replacement. The patient's 20-mm aortic annulus necessitated the use of a 23-mm Edwards S<jats:sc>apien<\/jats:sc> valve inserted through a 22F sheath, which itself needed a vessel diameter of at least 7 mm for percutaneous delivery. The left common femoral artery was selected for valve delivery. The left iliac artery and infrarenal aorta underwent extensive intervention to achieve an intraluminal diameter larger than 7 mm. After aortic valvuloplasty, valve deployment was successful, and the transaortic gradient decreased from 40 mmHg to less than 5 mmHg. The patient was discharged from the hospital 4 days postoperatively. We conclude that transcatheter aortic valve implantation can be successfully performed in patients with obstructed vascular access, including stenosis of the infrarenal aorta and the subclavian and coronary arteries.<\/jats:p>","DOI":"10.14503\/thij-13-4383","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T18:32:40Z","timestamp":1427913160000},"page":"144-147","source":"Crossref","is-referenced-by-count":2,"title":["Transcatheter Aortic Valve Implantation Despite Challenging Vascular Access"],"prefix":"10.14503","volume":"42","author":[{"given":"Angelo","family":"Nascimbene","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Azpurua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James J.","family":"Livesay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. David","family":"Fish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zvonimir","family":"Krajcer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"7","key":"i0730-2347-42-2-144-b1","series-title":"Am J Cardiol","first-page":"1058","article-title":"Early and late (one year) outcomes following transcatheter aortic valve implantation in patients with severe aortic stenosis (from the United States REVIVAL trial)","volume":"107","year":"2011","unstructured":"Kodali\n              SK, \n            \n              O'Neill\n              WW, \n            \n              Moses\n              JW, \n            \n              Williams\n              M, \n            \n              Smith\n              CR, \n            \n              Tuzcu\n              M, \n          \n          et al. Early and late (one year) outcomes following transcatheter aortic valve implantation in patients with severe aortic stenosis (from the United States REVIVAL trial). Am J Cardiol2011;107(7):1058\u201364."},{"issue":"6","key":"i0730-2347-42-2-144-b2","series-title":"Cardiovasc Revasc Med","first-page":"345","article-title":"Comparison between Society of Thoracic Surgeons score and logistic EuroSCORE for predicting mortality in patients referred for transcatheter aortic valve implantation","volume":"12","year":"2011","unstructured":"Ben-Dor\n              I, \n            \n              Gaglia\n              MA\n              Jr\n            , BarbashIM, MaluendaG, HauvilleC, GonzalezMA, \n          et al. Comparison between Society of Thoracic Surgeons score and logistic EuroSCORE for predicting mortality in patients referred for transcatheter aortic valve implantation. Cardiovasc Revasc Med2011;12(6):345\u20139."},{"issue":"11","key":"i0730-2347-42-2-144-b3","series-title":"JACC Cardiovasc Interv","first-page":"1150","article-title":"Complications and outcome of balloon aortic valvuloplasty in high-risk or inoperable patients","volume":"3","year":"2010","unstructured":"Ben-Dor\n              I, \n            \n              Pichard\n              AD, \n            \n              Satler\n              LF, \n            \n              Goldstein\n              SA, \n            \n              Syed\n              AI, \n            \n              Gaglia\n              MA\n              Jr, \n          \n          et al. Complications and outcome of balloon aortic valvuloplasty in high-risk or inoperable patients. 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Am J Cardiol2012;110(9):1361\u20137."},{"issue":"4","key":"i0730-2347-42-2-144-b7","series-title":"Catheter Cardiovasc Interv","first-page":"618","article-title":"Transcatheter aortic valve implantation through a diseased left common carotid artery: combined approach with endarterectomy and left carotid-subclavian bypass","volume":"81","year":"2013","unstructured":"Magalhaes\n              MA, \n            \n              Souza\n              JM, \n            \n              Grube\n              E. \n          \n          Transcatheter aortic valve implantation through a diseased left common carotid artery: combined approach with endarterectomy and left carotid-subclavian bypass. 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