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Severe intraprosthetic regurgitation by immobile leaflet after trans-catheter aortic valve implantation
Nawwar Al-Attar1, Dominique Himbert, Alec Vahanian
1Department of Cardiac Surgery, AP-HP, Bichat Hospital, University Paris 7, Paris, France. nawwar.al-attar@bch.aphp.fr
Abstract:
Aortic regurgitation mainly in the form of paravalvular leaks is a frequent complication of trans-catheter aortic valve implantation (TAVI). We describe a case of an 86-year-old woman with severe aortic stenosis, who underwent trans-apical TAVI with a 23-mm Edwards-SAPIEN valve. Immediately post-implantation, severe intravalvular leak was observed on trans-esophageal echocardiogram (TEE) due to an immobile cusp associated with left-ventricular distension and cardiovascular collapse. Despite successfully treating the leak with the implantation of a second valve of the same diameter within the first one, the hemodynamic status remained unstable. Peripheral extracorporeal membrane oxygenation (ECMO) was established but resulted in a fatal outcome due to intractable heart failure.
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