Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation
Left ventricular (LV) guidewire pacing has been proven to be a safe and effective pacing mode for transcatheter aortic valve replacement (TAVR). However, the high pacing voltage threshold and impedance of LV guidewire pacing are potential risks for loss of capture and valve embolization. Moreover, d...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1515954/full |
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| author | Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Wang Liao Wang Liao Wang Liao Wang Liao Wang Liao Lili Zhang Lili Zhang Lili Zhang Lili Zhang Lili Zhang Sheng Wang Sheng Wang Sheng Wang Sheng Wang Sheng Wang |
| author_facet | Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Wang Liao Wang Liao Wang Liao Wang Liao Wang Liao Lili Zhang Lili Zhang Lili Zhang Lili Zhang Lili Zhang Sheng Wang Sheng Wang Sheng Wang Sheng Wang Sheng Wang |
| author_sort | Ruisong Ma |
| collection | DOAJ |
| description | Left ventricular (LV) guidewire pacing has been proven to be a safe and effective pacing mode for transcatheter aortic valve replacement (TAVR). However, the high pacing voltage threshold and impedance of LV guidewire pacing are potential risks for loss of capture and valve embolization. Moreover, decisions surrounding whether and when to perform percutaneous coronary intervention (PCI) are always heterogeneous in patients with severe aortic stenosis and coronary artery disease. As described in this case report, we attempted an optimized LV guidewire pacing mode with the lowest pacing voltage threshold and impedance, avoiding complications associated with additional vascular access and further reducing TAVR costs. In addition, we successfully performed simultaneous PCI in this patient with a vertically downward orifice of the right coronary artery (RCA), severe calcified stenosis in the RCA, horizocardia, and a dilated ascending aorta. This case report provides new evidence for LV guidewire pacing and the opportunity for PCI in TAVR procedures. |
| format | Article |
| id | doaj-art-329650d986ff4c8783630ceb0c0096ce |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-329650d986ff4c8783630ceb0c0096ce2025-08-20T03:31:40ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.15159541515954Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitationRuisong Ma0Ruisong Ma1Ruisong Ma2Ruisong Ma3Ruisong Ma4Wang Liao5Wang Liao6Wang Liao7Wang Liao8Wang Liao9Lili Zhang10Lili Zhang11Lili Zhang12Lili Zhang13Lili Zhang14Sheng Wang15Sheng Wang16Sheng Wang17Sheng Wang18Sheng Wang19Department of Cardiology, Hainan General Hospital, Haikou, ChinaDepartment of Cardiology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Cardiology, Hainan Clinical Research Center for Cardiology, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Research and Cardiovascular Institute, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Medical Center, Haikou, ChinaDepartment of Cardiology, Hainan General Hospital, Haikou, ChinaDepartment of Cardiology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Cardiology, Hainan Clinical Research Center for Cardiology, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Research and Cardiovascular Institute, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Medical Center, Haikou, ChinaDepartment of Cardiology, Hainan General Hospital, Haikou, ChinaDepartment of Cardiology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Cardiology, Hainan Clinical Research Center for Cardiology, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Research and Cardiovascular Institute, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Medical Center, Haikou, ChinaDepartment of Cardiology, Hainan General Hospital, Haikou, ChinaDepartment of Cardiology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Cardiology, Hainan Clinical Research Center for Cardiology, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Research and Cardiovascular Institute, Haikou, ChinaDepartment of Cardiology, Hainan Province Clinical Medical Center, Haikou, ChinaLeft ventricular (LV) guidewire pacing has been proven to be a safe and effective pacing mode for transcatheter aortic valve replacement (TAVR). However, the high pacing voltage threshold and impedance of LV guidewire pacing are potential risks for loss of capture and valve embolization. Moreover, decisions surrounding whether and when to perform percutaneous coronary intervention (PCI) are always heterogeneous in patients with severe aortic stenosis and coronary artery disease. As described in this case report, we attempted an optimized LV guidewire pacing mode with the lowest pacing voltage threshold and impedance, avoiding complications associated with additional vascular access and further reducing TAVR costs. In addition, we successfully performed simultaneous PCI in this patient with a vertically downward orifice of the right coronary artery (RCA), severe calcified stenosis in the RCA, horizocardia, and a dilated ascending aorta. This case report provides new evidence for LV guidewire pacing and the opportunity for PCI in TAVR procedures.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1515954/fullaortic valve stenosiscoronary artery diseaseoptimized left ventricular guidewire pacingtranscatheter aortic valve replacementpercutaneous coronary intervention |
| spellingShingle | Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Ruisong Ma Wang Liao Wang Liao Wang Liao Wang Liao Wang Liao Lili Zhang Lili Zhang Lili Zhang Lili Zhang Lili Zhang Sheng Wang Sheng Wang Sheng Wang Sheng Wang Sheng Wang Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation Frontiers in Cardiovascular Medicine aortic valve stenosis coronary artery disease optimized left ventricular guidewire pacing transcatheter aortic valve replacement percutaneous coronary intervention |
| title | Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation |
| title_full | Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation |
| title_fullStr | Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation |
| title_full_unstemmed | Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation |
| title_short | Case Report: Optimized guidewire pacing in transcatheter aortic valve replacement combined with complex PCI in a patient with severe aortic stenosis and regurgitation |
| title_sort | case report optimized guidewire pacing in transcatheter aortic valve replacement combined with complex pci in a patient with severe aortic stenosis and regurgitation |
| topic | aortic valve stenosis coronary artery disease optimized left ventricular guidewire pacing transcatheter aortic valve replacement percutaneous coronary intervention |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1515954/full |
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