TEE-Guided Transcatheter Aortic Valve Implantation With "Zero Contrast" — A Viable Alternative for Patients With Chronic Kidney Disease

Ashish Pershad, MD; Ghassan Fraij, MD; Sudhakar V. Girotra, MD; H. Kenith Fang, MD; George Gellert, MD

J Invasive Cardiol. 2015;27(2):25-26.

Abstract and Introduction

Abstract

Acute kidney injury (AKI) stage II-III has been associated with a higher short-term and long-term mortality after transcatheter aortic valve replacement (TAVR). We present a patient with AKI where fluoroscopic landmarks and TEE imaging were used exclusively, sparing the patient a contrast load, and describe patient-tailored modifications.

Introduction

Transesophageal echocardiography (TEE) and intraoperative angiography are complementary imaging techniques in a transcatheter aortic valve replacement (TAVR) procedure. In this case, fluoroscopic landmarks and TEE imaging were used exclusively, sparing the patient a contrast load. Subtle iterations and patient-tailored modifications of this procedure are described.