A novel technique to manage transcatheter aortic valve embolization

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Surgery

Background:

• Severe aortic stenosis necessitates intervention, often transcatheter aortic valve replacement (TAVR).
• TAVR involves valve implantation via catheter, requiring careful procedural execution.

Observation:

• During TAVR, a 69-year-old male experienced loss of pacing capture and embolization of the Sapien 3 valve into the aortic arch.
• Initial attempts to retrieve the embolized valve were unsuccessful.

Findings:

• A second, larger valve (34mm Evolut R) was deployed in a valve-in-valve configuration.
• This successfully anchored the embolized valve within the transverse aortic arch without compromising branch vessels.

Implications:

• This case demonstrates a first-in-human application of a valve-in-valve approach to manage an embolized TAVR device in the aortic arch.
• This technique offers a potential solution for managing rare but serious TAVR procedural complications.