Combined transcarotid transcatheter aortic valve implantation and endarterectomy of the ipsilateral internal carotid artery

  • Arnaud Farge
  • Amir YoussariEmail author
  • Mohamad Oroudji
  • Mahmoud Fouda
Case report


The transcarotid pathway remains a safe route for transcatheter aortic valve implantation (TAVI) when more traditional approaches are contraindicated. We report a series of three patients with severe aortic stenosis (AS) and symptomatic significant stenosis of the ipsilateral internal carotid artery (ICA) in patients with high operative risk. All patients were treated successfully within the same setting in our center by endarterectomy first followed by a TAVI with an uneventful postoperative course without new neurological deficits (Modine et al. in J Thorac Cardiovasc Surg. 140:928–9, 2010; Azmoun et al. in Eur J Cardiothorac Surg. 46:693–8, 2014; Overtchouk et al. in Ann Cardiothorac Surg. 6(5):555–7, 2017).


Transcatheter aortic valve implantation Transcarotid access Endarterectomy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All patients were staffed with our heart team. Operative indications for transcarotid TAVI as well as for ipsilateral ICA endarterectomy were retained in a collegiate manner without any ethical problem raised.

Informed consent

Informed consent was obtained from all patients included in the study.


  1. 1.
    Modine T, Lemesle G, Azzaoui R, Sudre A. Aortic valve implantation with the CoreValve ReValving system via left carotid artery access: first case report. J Thorac Cardiovasc Surg. 2010;140:928–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Azmoun A, Amabile N, Ramadan R, et al. Transcatheter aortic valve implantation through carotid artery access under local anaesthesia. Eur J Cardiothorac Surg. 2014;46:693–8.Google Scholar
  3. 3.
    Overtchouk P, Alqdeimat I, Coisne A, Fattouch K, Modine T. Transcarotid approach for TAVI: an optimal alternative to the transfemoral gold standard. Ann Cardiothorac Surg. 2017;6:555–7.Google Scholar
  4. 4.
    Mylotte D, Sudre A, Teiger E, et al. Transcarotid Transcatheter aortic valve replacement: Feasibility and safety. JACC Cardiovasc Interv. 2016;9:472–80.Google Scholar
  5. 5.
    Pozzi M, Grinberg D, Obadia JF, et al. Transcatheter aortic valve implantation using the left transcarotid approach in patients with previous ipsilateral carotid endarterectomy. Catheter Cardiovasc Interv. 2015;85:E203–9.Google Scholar
  6. 6.
    AbuRahma AF. Predictors of perioperative stroke/death after carotid artery stenting: a review article. Ann Vasc Dis. 2018;11:15–24.Google Scholar
  7. 7.
    Nombela-Franco L, Webb JG, de Jaegere PP, et al. Timing, predictive factors, and prognostic value of cerebrovascular events in a large cohort of patients undergoing transcatheter aortic valve implantation. Circulation. 2012;126:3041–53.Google Scholar
  8. 8.
    Tsai R, Chen IM, Chen PL, Leu HB, Chen YH, Chang HH. Increase carotid flow by double sheath connection technique to reduce cerebral ischemia for transcatheter aortic valve implantation through transcarotid approach. Ann Thorac Cardiovasc Surg. 2018.

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2018

Authors and Affiliations

  • Arnaud Farge
    • 1
  • Amir Youssari
    • 1
    Email author
  • Mohamad Oroudji
    • 1
  • Mahmoud Fouda
    • 1
  1. 1.Cardiovascular Surgery CenterJacques Cartier HospitalMassyFrance

Personalised recommendations