Ipsilateral snare technique for the safe delivery of the Evolut PRO transcatheter aortic valve system: a case report

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Background: Transcatheter aortic valve implantation (TAVI) requires several bail-out techniques for safe valve delivery and deployment. Particularly in cases of challenging aortic anatomy, the snare technique from the contralateral side of the surgical site can facilitate delivery of the transcatheter heart valve (THV) system. However, there are no previous reports of the snare technique from the ipsilateral side of the surgical site in TAVI cases. Case summary: A 77-year-old woman presented with severe aortic stenosis and congestive heart failure. As computed tomography showed a heavily calcified aortic arch, we performed TAVI using the ipsilateral snare technique to control the direction of the Evolut THV system. There was no haematoma or excessive bleeding at the surgical site during the procedure, and the patient was discharged without complications. Discussion: In cases with challenging anatomy of the aorta, the ipsilateral snare technique may be useful for the safe delivery of the Evolut system.

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