Aortic Zone 0 Stenting in the Presence of a Metallic Aortic Valve: A Novel Technique of Loop Wire with a Trimmed Nosecone

Abstract

Aortic zone 0 stenting in the presence of a prosthetic pyrolytic carbon leaflet aortic valve is challenging as traversing the valve with a nosecone risks leaflet fracture. Trimming the nosecone leads to loss of smooth transition and the nosecone sticks to the greater curvature. A loop wire technique that helps guide the graft into the ascending aorta while staying clear of the aortic valve has not been described before.