This case illustrates the feasibility of using a balloon-expandable valve-in-valve procedure to treat severe paravalvular leak caused by prosthesis-annulus mismatch after self-expanding TAVI.
Single case of successful redo TAVI for PVL from mismatch; hypothesis-generating and should not change practice.
A 75-year-old male with severe symptomatic aortic stenosis underwent transcatheter aortic valve implantation with a Large (27-mm) ACURATE- neo transcatheter aortic valve, complicated by severe paravalvular leak. He developed rapid and progressive worsening heart failure. Reanalysis of the computed tomography images suggested evidence of prosthesis–annulus mismatch. Therefore, a redo transcatheter aortic valve implantation utilizing a 29-mm SAPIEN 3 transcatheter aortic valve was performed. This case illustrates the importance of proper valve sizing to avoid paravalvular leak, and how to safely cross an ACURATE- neo valve to avoid catheter entangling.
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Peverill et al. (2021) studied this question.
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