“Dual role” guiding catheter: a new technique for patients requiring coronary protection during transcatheter aortic valve implantation

Coronary occlusion is a life-threatening complication during transcatheter aortic valve implantation (TAVI) that requires immediate revascularization. Conventionally, a total of 3 catheters are required to protect the coronary ostia during TAVI: a pigtail catheter for the angiographic evaluation of valve positioning, a guiding catheter, and a TAVI delivery system. In this case series, we present a new, simplified technique for patients who require coronary protection during TAVI using a total of only 2 catheters: a guiding catheter and TAVI delivery system. This simplified technique results in a simpler procedure and reduces vascular complications in this high-risk cohort.