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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