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You are here: Contents > 2015 > Volume 24 Number 2 March 2015 > AORTIC VALVE DISEASE > Iatrogenic Mitral Valve Chordal Rupture During Placement of an Inflatable and Repositionable Percutaneous Aortic Valve Prosthesis

Iatrogenic Mitral Valve Chordal Rupture During Placement of an Inflatable and Repositionable Percutaneous Aortic Valve Prosthesis

Giuseppe D’Ancona, Hüseyin Ince, Jasmin Ortak, Yannik Stoeckicht, Stephan Kische

Department of Cardiology, Vivantes Kliniken im Friedrichshain und Am Urban, Berlin, Germany, Rostock University Medical Center, Rostock, Germany

A case is reported of iatrogenic mitral valve chordal rupture occurring during transcatheter aortic valve implantation (TAVI) with an inflatable and repositionable valve (Direct Flow®; Direct Flow Medical, Santa Rosa, CA, USA). The specific implantation technique requires initial valve advancement into the left ventricular cavity, valve inflation within the ventricular cavity, and a final finely tuned valve upward pulling through the left ventricular outflow tract until contact with the aortic annulus is achieved. During this

phase of the procedure, entangling with the mitral subvalvular apparatus should be excluded, to avoid inadvertent tissue tearing and consequent mitral valve malfunction. The present patient underwent TAVI but then developed symptomatic severe mitral valve regurgitation resulting from chordal rupture. The condition was successfully treated percutaneously by implanting a Mitra-Clip.

The Journal of Heart Valve Disease 2015;24:169-172

Iatrogenic Mitral Valve Chordal Rupture During Placement of an Inflatable and Repositionable Percutaneous Aortic Valve Prosthesis

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