A novel technique to manage transcatheter aortic valve embolization

Catheter Cardiovasc Interv. 2021 Apr 1;97(5):955-958. doi: 10.1002/ccd.29279. Epub 2020 Oct 10.

Abstract

We report a case of a 69-year-old male who was planned for a transcatheter aortic valve replacement (TAVR) with a 26 mm Sapien 3 Valve (Edwards Lifesciences, Irvine, California) for the treatment of symptomatic severe aortic stenosis. During rapid ventricular pacing and implantation of the TAVR valve, there was a loss of pacing capture and subsequent embolization of the valve into the aortic arch. Retrieval of the embolized valve was attempted unsuccessfully using several techniques. Finally, by using a 34 mm Evolut R Valve (Medtronic, Minneapolis, Minnesota), we were able to secure the embolized valve in the transverse segment of the aortic arch without compromising the branch vessels. To our knowledge, this is the first reported case of using a valve-in-valve approach to fixate an embolized valve in the transverse aorta.

Keywords: aortic stenosis; aortic valve disease; embolized valve rescue; structural heart disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Prosthesis Design
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Treatment Outcome