Transcatheter Aortic Valve Replacement in Patient With Extensive Aortic Dissection: Role of “Balloon Flossing”

A 70-year-old man presented with New York Heart Association (NYHA) class III symptoms secondary to severe bioprosthetic aortic valve insufficiency (Supplemental Video 1). The patient had a medical history of multiorgan sarcoidosis requiring prednisone and history of a type A (DeBakey Type I) dissection in 2018, which required a 27.0-mm Medtronic Freestyle aortic valve replacement, ascending aorta/full arch replacement with frozen elephant trunk replacement of descending thoracic aorta using a fenestrated distal stent graft covering left subclavian artery.