title: Sequential transcatheter aortic valve implantation due to valve dislodgement - a Portico valve implanted over a CoreValve bioprosthesis.
abstract: Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve®, which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved. After several months, she required another intervention, performed with a St. Jude Portico®repositionable self-expanding transcatheter aortic valve. There was a good clinical response that was maintained at one-year follow-up. The use of a self-expanding transcatheter bioprosthesis with repositioning features is a solution in cases of valve dislocation to avoid suboptimal positioning of a second implant, especially when the two valves have to be positioned overlapping or partially overlapping each other.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC), Faculdade de Ciências Médicas, Lisboa, Portugal. Electronic address: rcteles@outlook.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Campante Teles
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
authors.forename: Cátia
authors.initials: C
authors.lastname: Costa
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Almeida
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Brito
authors.affiliation: Serviço de Cardiologia, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Sondergaard
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: José P
authors.initials: JP
authors.lastname: Neves
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Abecasis
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: M Gabriel
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*
keywords: Complicações da válvula aórtica percutânea; Deslocamento da válvula; Estenose aórtica grave; Severe aortic stenosis; Transcatheter aortic valve implantation complications; Valve dislocation