title: Iatrogenic mitral valve chordal rupture during placement of an inflatable and repositionable percutaneous aortic valve prosthesis.
abstract: 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.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ancona
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
authors.forename: Jasmin
authors.initials: J
authors.lastname: Ortak
authors.forename: Yannik
authors.initials: Y
authors.lastname: Stoeckicht
authors.forename: Stephan
authors.initials: S
authors.lastname: Kische
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve; D002815:Chordae Tendineae / Q000293:injuries*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D012421:Rupture