Ahmad Abdelrehim, Ameer Abdelrahman, Ahmad Almagazzachi, Harit Desai, David Drucker
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Rescue and Redeploy: Successful Valve-in-Valve Implantation After Transcatheter Aortic Valve Embolization.
Background: Pacing failure is a common cause of transcatheter aortic valve replacement (TAVR) malposition and embolization. Transcatheter aortic valve embolization that compromises aortic branches usually necessitates open surgery. However, a salvage technique can address this complication percutaneously.
Case summary: We report a case involving a 26 mm Edwards transcatheter valve that was cephalically embolized during rapid pacing due to ventricular tachycardia with a single capture beat. The semiinflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position.
Conclusion: Carefully pulling back the embolized transcatheter aortic valve (TAV) to the area distal to the left subclavian artery is a viable salvage technique for embolized TAV. Another attempt of TAVR through the embolized valve can be safely performed, with careful monitoring of left ventricular capture during rapid pacing.Clinical ImpactQuestion: Can transcatheter aortic valve (TAV) embolization be solved percutaneously? Findings: The semi-inflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position. Results: Carefully pulling back an embolized TAV to the descending aorta is a viable salvage technique for managing embolized TAV.
期刊介绍：
The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.
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