양측 장골동맥협착을 동반한 환자에서 경대퇴동맥 접근법을 통한 경피적 대동맥판막 삽입술

Abstract

Transcatheter aortic valve implantation (TAVI) is an alternative treatment modality for surgical aortic valve replacement in patients at high surgical risk. Transfemoral access is not feasible in many cases with unfavorable iliofemoral anatomy or severe peripheral arterial disease (PAD). Elderly patients with severe aortic valve stenosis have a higher prevalence of PAD due to atherosclerotic degenerative changes in the large and small vessels. Transsubclavian, transapical, and direct access to the ascending aorta by thoracotomy are alternative routes for the TAVI procedure. In this case, we describe a patient with a previous coronary artery bypass graft and bilateral iliac artery stenosis who successfully underwent TAVI using a CoreValve® by transfemoral approach after balloon angioplasty of iliac artery stenosis.