Key result
Delayed valve expansion causes prophylactic chimney stent failure and cardiogenic shock after ViV TAVR.
Why the study?
Coronary ostium obstruction remains a significant complication of valve-in-valve transcatheter aortic valve replacement, and data on late failure of chimney stenting as a protective strategy are lacking.
Case Report (n=1)
Alerts to possible late chimney stent failure in ViV TAVR; leaves open need for alternative coronary protection strategies.
Although the safety of valve-in-valve transcatheter aortic valve replacement has improved, coronary ostium obstruction remains a significant complication, with chimney stenting a possible solution to circumvent this complication. In this case, we discuss the failure of a chimney stent in a case of valve-in-valve transcatheter aortic valve replacement resulting in cardiogenic shock. (Level of Difficulty: Advanced.)
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Nour et al. (2019) conducted a case report in Severe bioprosthetic aortic stenosis (n=1). Valve-in-valve transcatheter aortic valve replacement (TAVR-ViV) with prophylactic chimney stenting was evaluated on Late-presenting failed chimney stent resulting in cardiogenic shock. Prophylactic chimney stenting during valve-in-valve transcatheter aortic valve replacement failed 6 hours post-procedure due to progressive expansion of the valve, causing cardiogenic shock.
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