Percutaneous closure using an Amplatzer Vascular Plug II successfully treated a contained left ventricular apex perforation following TAVR valve-in-valve in an 80-year-old man.
Case Report (n=1)
Percutaneous closure using an Amplatzer Vascular Plug II may be a safe and effective alternative to high-risk surgical repair for iatrogenic left ventricular apex perforation following TAVR.
BACKGROUND: Transcatheter aortic valve replacement (TAVR) valve-in-valve (ViV) is a less invasive alternative to redo surgery for high-risk patients with failed bioprosthetic aortic valves. Left ventricular (LV) perforation is a rare but potentially life-threatening complication, typically requiring surgical repair. Percutaneous closure is seldom reported. CASE SUMMARY: An 80-year-old man with NYHA functional class III symptoms from severe degenerative transvalvular bioprosthetic aortic regurgitation underwent TAVR ViV. Postprocedure transthoracic echocardiogram and computed tomography scan revealed a small, contained LV apex perforation, likely iatrogenic from guidewire manipulation. This was successfully closed percutaneously using an Amplatzer Vascular Plug II. DISCUSSION: This case highlights importance of high-quality post-TAVR ViV transthoracic echocardiography and safety of percutaneous closure of LV apex perforation compared with surgical repair. TAKE-HOME MESSAGES: LV apex perforation is a rare but serious complication of TAVR. Percutaneous closure may avoid high-risk surgery in suitable cases.
Moussad et al. (Mon,) conducted a case report in Left ventricular apex perforation after TAVR valve-in-valve (n=1). Percutaneous closure using an Amplatzer Vascular Plug II was evaluated on Successful percutaneous closure. Percutaneous closure using an Amplatzer Vascular Plug II successfully treated a contained left ventricular apex perforation following TAVR valve-in-valve in an 80-year-old man.
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