Severe valvular regurgitation and late prosthesis embolization after percutaneous aortic valve implantation.
We report the case of a 79-year-old man with low-flow, low-gradient aortic stenosis who underwent transapical aortic valve implantation. The deployment of a 26-mm Edwards SAPIEN valve (Edwards Lifesciences Inc, Irvine, CA) was complicated with the occurrence of severe central aortic regurgitation that was successfully treated with the implantation of a second valve ("valve-in-valve"). Postoperative progress was satisfactory but 2 days after the procedure he suddenly developed cardiogenic shock secondary to the migration of the aortic bioprothesis into the left ventricular outflow tract. Open-heart surgery was undertaken to remove the valves and perform standard aortic valve replacement, but the patient died perioperatively.
Clavel
Marie-Annick
MA
Quebec Heart Institute/Laval Hospital, Quebec, Canada.
Dumont
Eric
E
Pibarot
Philippe
P
Doyle
Daniel
D
De Larochellière
Robert
R
Villeneuve
Jacques
J
Bergeron
Sebastien
S
Couture
Christian
C
Rodés-Cabau
Josep
J
D000368:Aged; D000792:Angiography; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D020878:Device Removal; D018450:Disease Progression; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011475:Prosthesis Failure; D012086:Reoperation; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000628:therapy; D013927:Thrombosis / Q000209:etiology* / Q000628:therapy