Coronary access following TAVI - Selective coronary engagement using balloon-assisted tracking of a guide catheter extension

Summary: performing percutaneous coronary intervention (PCI) following transcatheter aortic valve implantation (TAVI) will become more frequent with the increasing use of TAVI in lower surgical risk populations. The ideal management strategy for coronary artery disease (CAD) in the setting of TAVI is not well defined and CAD is often left untreated prior to TAVI. Engaging the coronary ostia through the TAVI side cells can be challenging; techniques for rapid coronary cannulation, especially in the acute setting, need to be developed. We present a case demonstrating balloon-assisted tracking of a GuideLiner guide catheter extension to selectively cannulate the left coronary ostium and facilitate successful PCI for an acute coronary syndrome.