Severe intraprosthetic regurgitation by immobile leaflet after trans-catheter aortic valve implantation.
Aortic regurgitation mainly in the form of paravalvular leaks is a frequent complication of trans-catheter aortic valve implantation (TAVI). We describe a case of an 86-year-old woman with severe aortic stenosis, who underwent trans-apical TAVI with a 23-mm Edwards-SAPIEN valve. Immediately post-implantation, severe intravalvular leak was observed on trans-esophageal echocardiogram (TEE) due to an immobile cusp associated with left-ventricular distension and cardiovascular collapse. Despite successfully treating the leak with the implantation of a second valve of the same diameter within the first one, the hemodynamic status remained unstable. Peripheral extracorporeal membrane oxygenation (ECMO) was established but resulted in a fatal outcome due to intractable heart failure.
Al-Attar
Nawwar
N
Department of Cardiac Surgery, AP-HP, Bichat Hospital, University Paris 7, Paris, France. nawwar.al-attar@bch.aphp.fr
Himbert
Dominique
D
Vahanian
Alec
A
Nataf
Patrick
P
D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011475:Prosthesis Failure / Q000009:adverse effects