Distal Anchor Balloon Technique to Facilitate Transcatheter Aortic Valve Delivery—A Case Report

Transcatheter aortic valve replacement has been established as an advanced therapeutic modality for severe aortic stenosis. Despite procedural advancements, anatomical variations may hinder successful prosthetic valve delivery in certain cases. Delivering a relatively bulky prosthesis through a constricted and extensively stenosed surgical bioprosthetic valve remains challenging. Such cases require alternative procedural strategies to enable smooth device navigation. In this case, the presence of a surgical tissue prosthesis with a Dacron conduit resulted in stacking of the delivery system within the aortic arch. An anchor balloon (20/45 mm) over a buddy wire was used to assist in guidewire compression and effective valve advancement.