Orthotopic Left Main Chimney Stenting to Prevent Stent Compression After Transcatheter Aortic Valve Replacement

• DOI: 10.1016/j.jaccas.2025.103286
• Publication Date: 2025-02-26T19:50:08Z
• Authors: Ruxandra I. Sava; Hakim Benamer; Julien Quillet; Maximilien Sochala; Philippe M. Garot; Mariama Akodad
• Keywords: Chimney (locomotive); Valve replacement

Coronary obstruction (CO) is a severe complication of transcatheter aortic valve replacement (TAVR). An 80-year-old woman presenting with stenosis was referred for TAVR. A preprocedural computed tomography revealed risk factors CO: narrow root and borderline-low coronary height. During TAVR, both coronaries were protected. After heart (THV) implantation, contrast staining the left sinus leaflet interaction main (LM) ostium noted, prompting LM stenting to prevent obstruction. Because THV-aorta space virtual, we opted rewiring through THV cell. postprocedural tomograohy permeable, well-expanded stent. Chimney between aorta may be unfeasible in patients because stent compression. Orthotopic chimney cell preferable classic minimal space.