ACURATE neo™ Aortic Valve implantation via carotid artery access: First case report

Abstract Background The ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) is predominantly implanted via femoral access. Implantation via the common carotid artery as an alternative arterial access has never been described.Case presentation We present the case of an 89-year-old woman referred to us for a transcatheter aortic valve replacement (TAVR). After apparatus imaging of the aortic annulus and the peripheral vascular pathway, the heart team was confronted with a triple challenge: (i) The preferable choice of a self-expanding valve because of a small aortic annulus in an obese woman. (ii) Gaining favorable access to the coronary ostia, considering multiple recent coronary stenting. (iii) Utilizing an alternative arterial access because of staggered iliac and femoral stenosis. Implanting the ACURATE neo™ transcatheter heart valve via carotidal access allowed us to overcome these challenges. The procedure was performed successfully without any short-term complications.Conclusion We report the first case of implantation of an ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) via the right common carotid artery.