title: Correction of aortic regurgitation after transcatheter aortic valve implantation of the Medtronic CoreValveTM prosthesis due to a too-low implantation, using transcatheter repositioning.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) has been introduced for the treatment of severe symptomatic aortic stenosis in patients not suitable for surgical valve replacement. However, a potential problem of TAVI is the development of severe aortic insufficiency after valve implantation due to a too-low implantation of the valve.
  
  
  METHODS
  Since August 2008, a total of 33 TAVI procedures using the 18 Fr Medtronic CoreValve ReValving system has been performed at the authors' institution.
  
  
  RESULTS
  Severe post-implantation aortic regurgitation occurred in three patients (9%), due to a too-low implantation. Two of these patients underwent a catheter-based repositioning of the valve using a standard snare; the third patient declined any further intervention. Both repositioning procedures were uneventful, with no significant residual regurgitation.
  
  
  CONCLUSIONS
  Severe aortic regurgitation after TAVI with the Medtronic CoreValve system is not uncommon. If the valve is implanted too low, a catheter-based valve repositioning may be the method of choice to resolve the problem.
authors.affiliation: Kardiologie/Pneumologie/Angiologie/Internistische Intensivmedizin, Herzzentrum Ludwigshafen, Bremserstrasse 79, D-67063 Ludwigshafen, Germany. erzahn@aol.com
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schiele
authors.forename: Caroline
authors.initials: C
authors.lastname: Kilkowski
authors.forename: Bärbel
authors.initials: B
authors.lastname: Klein
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Christiane
authors.initials: C
authors.lastname: Werling
authors.forename: Andreas
authors.initials: A
authors.lastname: Lehmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gerckens
authors.forename: Werner
authors.initials: W
authors.lastname: Saggau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005858:Germany; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012720:Severity of Illness Index; D016896:Treatment Outcome