Atheroma Retrieval During TAVR of Heavily Calcified Aorta: The Elevator Technique

Senguttuvan et al present an 86-year-old Caucasian female with severe symptomatic, inoperable aortic stenosis who was accepted for high-risk transfemoral transcatheter aortic valve replacement (TAVR) due to severe calcification of the aorta. During initial passage of a 22 Fr sheath, there was dislodgment with proximal migration of a circumferential tunnel of calcium from the infrarenal aorta. The accompanying video series demonstrates the novel “elevator” technique, which was used to secure and retrieve the dislodged aorta en bloc back to its original infrarenal aortic position and allow in situ fixation with stenting.