Embolization of aortic valve leaflet during valve-in-valve transcatheter aortic valve implantation: a case report

European Heart Journal. Case Reports
Sudhakar KinthalaSudhakar Sattur

Abstract

Aortic stenosis (AS) is one of the most common valvular disorders worldwide. An increasing number of transcatheter aortic valve implantation (TAVI) procedures are being performed yearly for managing AS. This, along with the occurrence of common complications, makes timely diagnosis essential to manage rare complications and improve patient outcomes. We present a case of a 77-year-old Caucasian male with severe AS with a dysfunctional bioprosthetic valve following previous surgical valve replacement. During valve-in-valve TAVI, we noted bioprosthetic valve leaflet avulsion and embolization causing a major vascular occlusion that resulted in vascular insufficiency of the left lower extremity. This condition was managed successfully via immediate diagnosis using transoesophageal echocardiogram, angiogram, and vascular surgical intervention for retrieving the embolized valve to re-establish circulation. To our knowledge, this is the first case of aortic valve leaflet embolization during TAVI resulting in significant vascular insufficiency. Vascular complications are common during TAVI. However, not all vascular complications are the same. Our case highlights an embolic vascular complication from an avulsed prosthetic material durin...Continue Reading

References

Sep 19, 2006·Lancet·Vuyisile T NkomoMaurice Enriquez-Sarano
Aug 19, 2016·Journal of Interventional Cardiology·Gautam R PatankarRobert C Stoler
Jun 22, 2017·The Annals of Thoracic Surgery·Dimitri SherevRicardo Moreno-Cabral
Jul 25, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Pedro A VillablancaHarish Ramakrishna
Aug 3, 2017·JAMA Cardiology·Rick A NishimuraRobert O Bonow
Feb 21, 2019·JACC. Cardiovascular Interventions·Suzanne V ArnoldDavid J Cohen

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