Transcatheter Aortic Valve Embolization in a Patient With a Left Ventricular Assist Device

Figures

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  Figure 1. Two-dimensional TEE, midesophageal long-axis (top row) and short-axis (bottom row) views in diastole, without (left) and with (right) color-flow Doppler, demonstrates appropriate LVAD inflow cannula position (A), severe AR (B), poorly visualized aortic leaflets (C), and lack of coaptation along the edge of the left coronary cusp (D).

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  Figure 2. Two-dimensional TTE, parasternal long-axis view after valve deployment, demonstrates the embolized TAVI prosthesis within the LV.

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  Figure 3. Two-dimensional TEE, midesophageal 4-chamber view, systolic frame, demonstrates the echo-bright, circular mass appearance of the balloon expandable valve adjacent to, and partially obstructing, the LVAD inflow cannula.

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  Figure 4. Intraprocedural two-dimensional TEE, midesophageal 4-chamber view, demonstrates the balloon expandable valve settled over the LVAD inflow cannula leading to obstruction of the LVAD flow.

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  Figure 5. Postoperative two-dimensional TEE, midesophageal aortic valve short-axis view with color-flow Doppler, demonstrates marked PVR around the TAVI device.