title: Sigmoid Septum and Balloon-Expandable Transcatheter Aortic Valve Replacement: A Cautionary Tale.
abstract: Transcatheter aortic valve replacement (TAVR) continues to garner considerable attention, especially as the commercial use of the procedure grows. Herein is highlighted an under-reported, underappreciated challenge in TAVR--that of a sigmoid septum. The two cases reported constitute the first discussion in the contemporary literature of this unique geometry in the setting of TAVR. Specifically, the report addresses how such a bulging septum may preclude safe TAVR with a balloon- expandable prosthesis, and also reinforces the importance of thoroughly evaluating all aspects of the subvalvular anatomy prior to valve deployment.
authors.forename: Andreas R
authors.initials: AR
authors.lastname: de Biasi
authors.forename: Berhane
authors.initials: B
authors.lastname: Worku
authors.forename: Nikolaos J
authors.initials: NJ
authors.lastname: Skubas
authors.forename: Arash
authors.initials: A
authors.lastname: Salemi
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D063126:Balloon Valvuloplasty / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006332:Cardiomegaly / Q000150:complications* / Q000175:diagnosis; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D054088:Ventricular Septum / Q000000981:diagnostic imaging