Delayed migration of a Sapien 3 Ultra Resilia following transcatheter aortic valve implantation after selection of a smaller-sized valve.

IF 0.5 Q3 MEDICINE, GENERAL & INTERNAL
Oxford Medical Case Reports Pub Date : 2024-07-09 eCollection Date: 2024-07-01 DOI:10.1093/omcr/omae065
Nagiko Mitsuoka, Tohru Takaseya, Ken-Ichiro Sasaki, Kazuyoshi Takagi, Naoki Itaya, Kensuke Oshita, Masahiro Sasaki, Michiko Yokomizo, Yume Nohara, Hidefumi Kuroki, Yoshihiro Fukumoto, Eiki Tayama
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引用次数: 0

Abstract

This report discusses a rare case of delayed migration of a Sapien 3 Ultra Resilia (S3UR) valve following transcatheter aortic valve implantation. An 81-year-old Japanese woman had a borderline aortic annular size of 20-23 mm according to the manufacturer's size chart. We chose to implant a smaller S3UR of 20 mm with an 80/20 depth ratio to allow for a second intervention, ensuring good hemodynamics and minimizing paravalvular leak. The patient initially had a favorable outcome despite an accidental 50/50 depth ratio during implantation. On postoperative day 3, the S3UR migrated into the left ventricular outflow tract. Emergency surgical aortic valve replacement was performed to retrieve the migrated valve. Use of the S3UR has led to a growing preference for smaller valve sizes. However, the risk of migration should be recognized. When an accidental 50/50 depth ratio implantation is encountered, post-dilation or second valve implantation should be performed immediately.

选择较小尺寸的瓣膜后,经导管主动脉瓣植入术后 Sapien 3 Ultra Resilia 发生延迟移位。
本报告讨论了一例罕见的经导管主动脉瓣植入术后 Sapien 3 Ultra Resilia(S3UR)瓣膜延迟移位的病例。一位81岁的日本妇女的主动脉瓣环尺寸为20-23毫米(根据制造商的尺寸表)。我们选择植入一个较小的 20 毫米 S3UR,深度比为 80/20,以便进行第二次介入,确保良好的血液动力学并最大限度地减少瓣膜旁漏。尽管在植入过程中意外出现了 50/50 的深度比,但患者最初的治疗效果良好。术后第 3 天,S3UR 移入左室流出道。紧急进行了主动脉瓣置换手术,以取出移位的瓣膜。S3UR 的使用使越来越多的人倾向于使用较小尺寸的瓣膜。但是,应该认识到瓣膜移位的风险。当遇到意外的 50/50 深度比植入时,应立即进行后扩张或第二次瓣膜植入。
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来源期刊
Oxford Medical Case Reports
Oxford Medical Case Reports MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
125
审稿时长
19 weeks
期刊介绍: Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.
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