title: An Extreme Case of CoreValve Bioprosthesis Embolization into the Abdominal Aorta and of the Delivery Catheter Cone into the Right Internal Iliac Artery.
abstract: Transcatheter aortic valve implantation (TAVI) is a new and hopefully therapeutic option in patients with symptomatic severe calcific aortic valve stenosis and multiple comorbidities who are not eligible for open-heart surgery due to unacceptable conventional surgical risks. Herein is reported the case of a patient who underwent TAVI in whom an unusual CoreValve bioprosthesis embolization occurred into the abdominal aorta. While attempting to retrieve the whole system, the conical tip of the catheter delivery system also became embolized into the right iliac artery. Importantly, this case demonstrated a rare complication of CoreValve bioprosthesis embolization which was managed without surgical intervention. Video 1: Peripheral angiography demonstrating the embolized CoreValve bioprosthesis. Video 2: Fluoroscopy demonstrating completely opened CoreValve bioprosthesis at a level above the iliac artery bifurcation and the mobile conical tip in the valve system. Video 3: Peripheral angiography demonstrating prosthetic valve without any flow limitation and embolized conical tip into the right internal iliac artery. Video 4: Peripheral angiography demonstrating prosthetic valve without any flow limitation and embolized conical tip into the right internal iliac artery. Video 5: Aortography demonstrating the successfully implanted second CoreValve bioprosthesis in an optimal aortic position, with no paravalvular leak. Video 6: Peripheral angiography demonstrating the embolized conical tip into the right iliac artery with a normal external iliac artery flow. Video 7: Peripheral angiography demonstrating the embolized conical tip into the right iliac artery with a normal external iliac artery flow.
authors.affiliation: Ataturk Education and Research Hospital, Division of Cardiology, Ankara.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Alsancak
authors.affiliation: Ataturk Education and Research Hospital, Division of Cardiology, Ankara.|Yildirim Beyazit University, Faculty of Medicine, Division of Cardiology, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bilge
authors.affiliation: Ataturk Education and Research Hospital, Division of Cardiology, Ankara.
authors.forename: Sina
authors.initials: S
authors.lastname: Ali
authors.affiliation: Ataturk Education and Research Hospital, Division of Cardiology, Ankara.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
authors.affiliation: Ataturk Education and Research Hospital, Division of Cardiology, Ankara.
authors.forename: Ayse
authors.initials: A
authors.lastname: Saatci Yasar