Transcatheter aortic valve replacement via femoral artery for aortic regurgitation post-LVAD: a case report

Figures

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  Figure 1. Moderate to severe regurgitation of the aortic valve.

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  Figure 2. Preoperative CT evaluation. (A) Annular circumference diameter: 19.8 mm; (B) outflow tract circumference diameter: 23.2 mm; (C) sinus of valsalva circumference diameter: 31.3 mm; (D) sinus of valsalva diameter: 31.8 mm, 29.5 mm, 31.9 mm; (E) sinutubular junction circumference diameter: 27.5 mm; (F) aortic circumference diameter 4 cm above the annulus: 34.3 mm; (G,H) no significant calcification observed in the annulus and leaflets; (I) height of the left coronary artery ostium: 11.9 mm; (J) height of the right coronary artery ostium: 9.3 mm.

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  Figure 3. Transcatheter aortic valve replacement via femoral artery. (A) Deliver the valve to the annulus location; (B) deploy the proprietary locator into the sinus of valsalva; (C) release the valve; (D) angiography shows no regurgitation of the aortic valve and no impact on coronary perfusion.

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  Figure 4. Intraoperative transesophageal echocardiography monitoring. (A) No paravalvular leak on short-axis view; (B) long-axis view indicates adequate valve depth, no impairment of anterior mitral leaflet function; (C) ultrasound color Doppler shows no aortic regurgitation.

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  Figure 5. One-month postoperative echocardiographic follow-up. (A) Spectral Doppler showing no evidence of aortic regurgitation; (B) long-axis view demonstrating no late prosthetic valve migration.