Successful percutaneous aortic valve implantation via a stenotic left subclavian artery access

Severe aortic valve stenosis may be tackled with percutaneous aortic valve replacement instead of surgical replacement. At present, two CE marked prosthetic valves are available. The Core Valve ReValving System is primarily designed to be introduced transfemorally, while implantation via subclavian arteries has been described in cases of unsuitable femoral access. However, this route has been used when subclavian artery is free of disease. In this case report we describe a successful Core Valve ReValving System implantation via a diseased and tortuous left subclavian artery after predilatation balloon angioplasty. The prosthesis was then advanced in the native aortic valve, deployed, and successfully implanted. Techniques and manipulations are provided.