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Zero Contrast Transfemoral Transcatheter Aortic Valve Replacement Using Fluoroscopy-Echocardiography Fusion Imaging

      Acute kidney injury (AKI) remains a major concern in the field of TAVR and is associated with increased mortality, up to twofold to eightfold.
      • Najjar M.
      • Salna M.
      • George I.
      Acute kidney injury after aortic valve replacement: incidence, risk factors and outcomes.
      Although the exact mechanism of post-TAVR AKI is unknown and seems to be multifactorial, contrast has been reported as a contributing factor.
      • Elhmidi Y.
      • Bleiziffer S.
      • Deutsch M.A.
      • Krane M.
      • Mazzitelli D.
      • Lange R.
      • Piazza N.
      Acute kidney injury after transcatheter aortic valve implantation: incidence, predictors and impact on mortality.
      During TAVR, contrast is used for conventional aortic root angiography, for positioning of the TAVR valve device and assessing the peripheral vasculature. To our knowledge, for the first time, we report transfemoral TAVR performed with zero contrast using fluoroscopy and ultrasound guidance. This was done in two patients with symptomatic, severe aortic stenosis, and significant chronic kidney disease (stage III) who were deemed high risk for surgical aortic valve replacement after discussion in the multidisciplinary Heart Team meeting.
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      References

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        • Salna M.
        • George I.
        Acute kidney injury after aortic valve replacement: incidence, risk factors and outcomes.
        Expert Rev Cardiovasc Ther. 2015; 13: 301-316
        • Elhmidi Y.
        • Bleiziffer S.
        • Deutsch M.A.
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        • Piazza N.
        Acute kidney injury after transcatheter aortic valve implantation: incidence, predictors and impact on mortality.
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