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You are here: Contents > 2015 > Volume 24 Number 1 January 2015 > CASE REPORT > A Case of Iatrogenic Chordal Rupture after Transcatheter Aortic Valve Implantation Procedure Requiring a Second Valve

A Case of Iatrogenic Chordal Rupture after Transcatheter Aortic Valve Implantation Procedure Requiring a Second Valve

Altug Cincin, Kursat Tigen, Ibrahim Sari, Murat Sunbul, Fatih Kartal, Yelda Basaran

Marmara University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey

Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic option for high-risk aortic stenosis. Malposition of the prosthesis and severe residual aortic regurgitation are known complications of the procedure, which might require a second valve implantation. Although the implantation of a second valve seems to be an effective method, very few data are available describing this technique. Herein is reported a case of iatrogenic chordal rupture in a TAVI procedure which required a second valve implantation due to dislodgment of the first prosthesis.

Movie 1: Pre-procedural aortography. Moderate aortic regurgitation. [click here to view]

Movie 2: Placement of the first prosthesis. Positioning the prosthesis 4-6 mm below the base of the native aortic annulus. [click here to view]

Movie 3: Deployment of the first prosthesis. The base of the system was still below the annular calcification. [click here to view]

Movie 4: The dislocated prosthesis. Dislocated prosthesis and severe aortic regurgitation. [click here to view]

Movie 5: Implantation of the second prosthesis. Mild aortic regurgitation after implantation of the second prosthesis in the correct position. [click here to view]

Movie 6: Echocardiographic view after implantation of the second prosthesis. Moderate mitral and mild aortic regurgitation after successful deployment of the second prosthesis. [click here to view]

Movie 7: Oscillating chordal leaflet (long-axis view). The flail chordal leaflet oscillates through the outflow tract at each systole. [click here to view]

Movie 8: Oscillating chordal leaflet (trans-gastric view). The flail chordal leaflet oscillates between the inside of the ventricle and the outflow tract. [click here to view]

The Journal of Heart Valve Disease 2015;24:133-138


A Case of Iatrogenic Chordal Rupture after Transcatheter Aortic Valve Implantation Procedure Requiring a Second Valve

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