{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:58:58Z","timestamp":1779249538351,"version":"3.51.4"},"reference-count":2,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Symptomatic severe aortic stenosis (AS) in patients with intermediate-to-high surgical risk is currently being treated with transcatheter aortic valve replacement (TAVR). We present a case of a TAVR in a severe calcific AS with porcelain aorta and \u2018gothic\u2019 aortic arch. Pre-operative thoraco-abdominal computed tomography angiography showed also severe calcification at the sinotubular junction with protruding huge calcified nodules extending in ascending aorta and multiple calcific stenosis of both iliac-femoral vessels, severely tortuous. The choice of the interventional access was not easy and the high risk of an acute intra-procedural brain event guided the procedural planning. To our knowledge, this is the first case of TAVR with complete cerebral protection with Triguard system device and \u2018snaring-assisted\u2019 valve advancement.<\/jats:p>","DOI":"10.3389\/fcvm.2023.1213817","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T13:06:12Z","timestamp":1697807172000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report of snaring-assisted TAVR under cerebral embolic protection: the \u201cChaperone\u201d with \u201cTop Hat\u201d technique"],"prefix":"10.3389","volume":"10","author":[{"given":"Massimo","family":"Medda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Casilli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Bande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Tespili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Donatelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1016\/j.jcin.2019.08.046","article-title":"The \u201cchaperone technique\": valve-in-valve TAVR procedure with a self-expandable valve inside a degenerated sutureless prosthesis","volume":"13","author":"Medda","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.carrev.2021.02.018","article-title":"Snaring the transcatheter heart valve delivery system during aortic valve replacement: when and why","author":"Buono","year":"2021","journal-title":"Cardiovasc Revasc Med"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1213817\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T13:06:18Z","timestamp":1697807178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1213817\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,20]]},"references-count":2,"alternative-id":["10.3389\/fcvm.2023.1213817"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1213817","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,20]]},"article-number":"1213817"}}