Cedars sinai smidt heart institute8/17/2023 During a median follow-up time of 612 days (interquartile range: 405 to 842 days), 2 cases of stent failure were reported (1 in-stent restenosis, 1 possible late stent thrombosis) after 157 and 374 days.Ĭhimney stenting appears to be an acceptable bailout technique for CAO, with higher event rates among those with established CAO and among those without upfront coronary protection.Ĭhimney stenting coronary artery obstruction coronary protection myocardial infarction transcatheter aortic valve replacement.Ĭopyright © 2020 American College of Cardiology Foundation. The absence of upfront coronary protection was the sole independent risk factor for the combined endpoint of death, cardiogenic shock, or myocardial infarction. 2.9% p < 0.01) all occurred more frequently in patients with established CAO compared with those with impending CAO. Procedural and in-hospital mortality occurred in 1 and 2 patients, respectively. Upfront coronary protection was performed in 44 patients (73.3%). The majority of cases (92.9%) had 1 or more classical risk factors for CAO. Chimney stenting was performed for 2 reasons: 1) due to the development of an established CAO (n = 25 ) or 2) due to an impending CAO (n = 35 ). To date, 16 centers have contributed 60 cases among 12,800 TAVR procedures (0.5%). In the international Chimney Registry, patient and procedural characteristics and data on outcomes are retrospectively collected from patients who underwent chimney stenting during TAVR. Electronic address: aim of this study was to determine the safety and efficacy of chimney stenting, a bailout technique to treat coronary artery occlusion (CAO).ĬAO during transcatheter aortic valve replacement (TAVR) is a rare but often fatal complication. 20 University Hospital and SAOLTA University Health Care Group, Galway, Ireland National University of Ireland, Galway, Ireland.19 McGill University Health Centre, Montreal, Quebec, Canada.18 Institut Cardiovasculaire de Paris, Massy, France.17 Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle, Washington.16 Tel Aviv Medical Center and Tel Aviv University, Tel Aviv, Israel. 15 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.14 Department of Cardiology, Institut Mutualiste Montsouris, Paris, France.13 Department of General and Interventional Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.12 Hemodynamic Department, Centre Cardiologique du Nord, Saint Denis, France.11 Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili of Brescia, Brescia, Italy.10 Clinique Pasteur, Groupe Cardiovasculaire Interventionel, Toulouse, France.9 Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.8 Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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