Successful delayed endovascular correction of migration of transcatheter aortic valve prosthesis in left ventricle outflow tract: case report

Q4 Medicine

Patologiya krovoobrashcheniya i kardiokhirurgiya Pub Date : 2021-12-28 DOI:10.21688/1681-3472-2021-4-112-117

A. D. Gorovaya, D. D. Zubarev, V. Krasnov, M. Chernyavskiy, A. Prokhorikhin

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Abstract

We report the successful endovascular correction of the migration of a transcatheter aortic valve prosthesis in the left ventricle outflow tract (LVOT). A 72-old man was underwent transcatheter aortic valve implantation (TAVI) at Almazov National Medical Research Centre for severe aortic stenosis. During the procedure, the self-expanding prosthesis dislocated 10–12 mm into the LVOT. The frame was optimised with the use of a balloon catheter, and aortic regurgitation I-II degree was achieved. However, on day 17 of hospitalisation, acute heart failure with episodes of asystole occurred as a result of severe paravalvular regurgitation; cardiopulmonary resuscitation was necessary. The prosthesis malpositioning was corrected by traction with endovascular snare devices. The patient was stable during the postprocedural period and discharged on day 31. Dislocation of self-expanding prostheses into the LVOT is a complication specific to TAVI that may quickly aggravate a patient’s condition; therefore, correction of valve malpositioning should be performed as soon as possible. The case reported here in an illustration of successful endovascular correction of dislocation performed with the snare traction technique. This bail-out approach can be used by interventional cardiologists in similar situations.Received 27 May 2021. Revised 29 July 2021. Accepted 30 July 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Contribution of the authors Literature review: A.D. Gorovaya, D.D. Zubarev, A.A. Prokhorikhin Drafting the article: A.D. Gorovaya, V.S. Krasnov, A.A. Prokhorikhin Critical revision of the article: A.D. Gorovaya, M.A. Chernyavskiy, A.A. Prokhorikhin Surgical treatment: D.D. Zubarev, V.S. Krasnov, A.A. Prokhorikhin Final approval of the version to be published: A.D. Gorovaya, D.D. Zubarev, V.S. Krasnov, M.A. Chernyavskiy, A.A. Prokhorikhin

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经导管主动脉瓣假体左心室流出道移位延迟血管内矫正成功1例

我们报道一例成功的经导管主动脉瓣假体在左心室流出道(LVOT)的血管内矫治。一位72岁的老人因严重主动脉狭窄在Almazov国家医学研究中心接受了经导管主动脉瓣植入术(TAVI)。在手术过程中，自膨胀假体脱位10 - 12mm进入LVOT。使用球囊导管优化框架，主动脉返流达到I-II度。然而，在住院第17天，由于严重的瓣旁反流，急性心力衰竭伴心脏骤停发作;心肺复苏是必要的。采用血管内圈套装置牵引修复假体错位。术后患者病情稳定，31天出院。自膨胀假体脱位进入左腔静脉是TAVI特有的并发症，可能会迅速加重患者的病情;因此，应尽快对阀门错位进行矫正。本文报告的病例是用圈套牵引技术成功进行血管内脱位矫正。在类似的情况下，介入心脏病专家可以使用这种救市方法。收到2021年5月27日。2021年7月29日修订。2021年7月30日接受。经费来源:本研究未获得赞助。利益冲突:作者声明无利益冲突。作者贡献文献综述:A.D. Gorovaya, D.D. Zubarev, A.A. Prokhorikhin撰写文章:A.D. Gorovaya, V.S. Krasnov, A.A. Prokhorikhin文章的关键修改:A.D. Gorovaya, M.A. Chernyavskiy, A.A. Prokhorikhin手术治疗:D.D. Zubarev, V.S. Krasnov, A.A. Prokhorikhin最终批准出版的版本:A.D. Gorovaya, D.D. Zubarev, V.S. Krasnov, M.A. Chernyavskiy, A.A. Prokhorikhin

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