Key result
Third TAVI valve deployed within the first resolves severe leak and shock after second valve embolization.
Why the study?
Transcatheter aortic valve implantation is a novel therapy for high-risk severe aortic stenosis patients, but procedural complications can cause devastating outcomes.
Case Report (n=1)
Deployment of a third transcatheter heart valve within the first can successfully treat severe intraprosthetic regurgitation even after a second valve embolizes.
This case describes a bailout for TAVR embolization with leak; hypothesis-generating and should not yet change practice.
Transcatheter aortic valve implantation is a novel therapeutic approach for high-risk patients with severe symptomatic aortic stenosis. The success rate of this new procedure is high; however, procedural complications can occur and may result in devastating outcomes. Here, we report a case of transfemoral catheter aortic valve implantation using the Edwards SAPIEN valve complicated by severe intravalvular leak due to immobile cusp associated with shock. We treated with a second valve that embolized and deployed in the descending aorta. A third valve was then deployed within the first with elimination of aortic regurgitation and immediate hemodynamic improvement.
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Ben‐Dor et al. (2012) conducted a case report in Severe symptomatic aortic stenosis (n=1). Transfemoral catheter aortic valve implantation (Edwards SAPIEN valve) was evaluated. Transfemoral catheter aortic valve implantation complicated by severe intravalvular leak and shock was successfully managed by deploying a third valve within the first after a second valve embolized.
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