Transcatheter Aortic Valve Migration During Vascular Access Closure

Figures

• 

  Figure 1. Cine-fluoroscopy of the migrated transcatheter heart valve (THV). Fluoroscopy shows superior migration of the THV into the ascending aorta with patent left and right coronary arteries.

• 

  Figure 2. Transcatheter heart valve (THV) snaring. The THV was snared with a 20 mm Gooseneck snare and pulled back into the ascending aorta superior to the coronary ostia.

• 

  Figure 3. Second transcatheter heart valve (THV) delivery. Back-tension was maintained on the original THV as a new prosthesis was delivered into the aortic root.

• 

  Figure 4. Second transcatheter heart valve (THV) deployment. The second THV self-expanded into the appropriate location while tacking down the leaflets of the original THV.

• 

  Figure 5. Final dual transcatheter heart valve (THV) location. The second THV deployed appropriately in the aortic root.

• 

  Figure 6. TTE color Doppler after TAVR without evidence of pericardial effusion. There is no post-deployment regurgitation by color Doppler assessment. TTE, transthoracic echocardiography; TAVR, transcatheter aortic valve replacement.

• 

  Figure 7. TTE spectral Doppler after TAVR of the LVOT (A) and aortic valve (B). Spectral Doppler tracings demonstrate trans-prosthetic peak velocity and dimensionless index within the normal range for valve type (1.85 m/s and 0.66, respectively). TTE, transthoracic echocardiography; TAVR, transcatheter aortic valve replacement; LVOT, left ventricular outflow tract.