title: Salvaging lowermost deployment of an acurate device during transcatheter aortic valve replacement with balloon and lasso pull techniques.
abstract: Transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI), is being used with increasing frequency in patients with severe aortic stenosis at high or prohibitive surgical risk. A number of devices are becoming available for TAVR, and competence in using them is mandatory to maximize the safety and efficacy of TAVR, while individualizing device selection in keeping with patient features. The ACURATE TF is a novel promising device for transfemoral TAVR. However, its peculiar features may require additional maneuvers in case of complications. We hereby report the case of a patient undergoing transfemoral TAVR with the ACURATE TF device, in whom lowermost deployment was complicated by massive aortic regurgitation. With two separate remedial actions, the balloon pull and lasso techniques, we were able to pull back the device and significantly reduce post-TAVR aortic regurgitation. Awareness of this complication and the possible use of these two techniques may increase the safety and efficacy of TAVR with this and other new devices. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Unità Operativa Di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy.|Unità Operativa Di Emodinamica, Casa Di Salute Santa Lucia, San Giuseppe Vesuviano, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Corcione
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. giuseppe.biondizoccai@uniroma1.it.|Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy. giuseppe.biondizoccai@uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.affiliation: Unità Operativa Di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy.|Unità Operativa Di Emodinamica, Casa Di Salute Santa Lucia, San Giuseppe Vesuviano, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Giordano
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002406:Catheterization, Peripheral; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011677:Punctures; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: aortic stenosis; complication; transcatheter aortic valve implantation; transcatheter aortic valve replacement