What does this research mean for the field?

Transaxillary TAVI resulted in entrapment of a 27.5 mm Myval valve in the subclavian artery, which was subsequently treated successfully through a transfemoral approach with a 29 mm Evolut-R valve. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This report aims to highlight a rare complication of bioprosthetic valve entrapment during transaxillary TAVI and its management.

February 8, 2026

A rare complication of transaxillary TAVI: Management of a bioprosthetic valve entrapment in the subclavian artery

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: A 75-year-old male patient with severe iliofemoral calcification, low-flow low-gradient severe aortic stenosis with contractile reserve, LVEF 40%, and NYHA class III symptoms (n=1). Intervention: Transaxillary transcatheter aortic valve implantation (TAx-TAVI) with 27.5 mm balloon expandable Myval valve followed by transfemoral TAVI with 29 mm Evolut-R valve. Primary outcome: Successful implantation of transcatheter aortic valve without vascular complications after managing valve entrapment.

Resultado clave

A bioprosthetic valve entrapped in the subclavian artery after transaxillary TAVI was successfully managed by implanting the valve in the artery and subsequently performing transfemoral TAVI with a low-profile sheathless system 2 weeks later without complications.

Puntos clave

This report aims to highlight a rare complication of bioprosthetic valve entrapment during transaxillary TAVI and its management.
Described an unusual case of valve entrapment in the subclavian artery.
Documented the patient's profile, including severe iliofemoral calcification.
Outlined the management using a subsequent transfemoral approach with a sheathless system.
The bioprosthetic valve became entrapped in the subclavian artery, a complication reported for the first time.
Successful treatment was achieved through a low-profile sheathless system via the transfemoral route.

Diseño del estudio

Tipo

Case Report (n=1)

Multicéntrico

PICO estructurado

Población

75-year-old male patient with severe iliofemoral calcification and low-flow, low-gradient severe aortic stenosis (NYHA class III, LVEF 40%, STS score 4.7%) undergoing transaxillary TAVI.

Intervención

Management of transcatheter aortic valve entrapment by deploying a 27.5 mm balloon-expandable valve in the subclavian artery, followed by a second session of transfemoral TAVI using a 29 mm self-expanding valve with a sheathless system.

Entrapment of a transcatheter aortic valve during transaxillary access can be safely managed by deploying the valve in the subclavian artery, followed by successful transfemoral TAVI using a low-profile sheathless system.

Limitaciones

Single patient case report limiting generalizability
No control or comparator group
No long-term follow-up data provided

Resumen

The transaxillary (TAx) approach represents the most commonly preferred alternative access route for transcatheter aortic valve implantation (TAVI) when transfemoral (TF) access is not feasible. Therefore, vascular complications and their management remain of particular importance. In this case report, we present a 75-year-old male patient with severe iliofemoral calcification who underwent TAx-TAVI and developed entrapment of the transcatheter aortic valve in the subclavian artery- a complication reported here for the first time in the literature. The entrapped valve was implanted in the subclavian artery and in the second session, the patient was successfully treated via the TF route using a low-profile in-line sheath (sheathless) system.

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Cite This Study

Uslu et al. (Fri,) conducted a case report in A 75-year-old male patient with severe iliofemoral calcification, low-flow low-gradient severe aortic stenosis with contractile reserve, LVEF 40%, and NYHA class III symptoms (n=1). Transaxillary transcatheter aortic valve implantation (TAx-TAVI) with 27.5 mm balloon expandable Myval valve followed by transfemoral TAVI with 29 mm Evolut-R valve was evaluated on Successful implantation of transcatheter aortic valve without vascular complications after managing valve entrapment. A bioprosthetic valve entrapped in the subclavian artery after transaxillary TAVI was successfully managed by implanting the valve in the artery and subsequently performing transfemoral TAVI with a low-profile sheathless system 2 weeks later without complications.

synapsesocial.com/papers/698828100fc35cd7a8847433 https://doi.org/https://doi.org/10.4274/tjtcs.2025.28745

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