Related Experiment Video
Updated: Sep 25, 2025
06:59
Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
10.7K
Strut Inversion During Valve-in-Valve Transcatheter Aortic Valve Replacement: An Unknown Complication?
Akash Batta1, Sai Satish2, Ajay Rajan1
1Department of Cardiology, Advanced Cardiac Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
JACC. Case Reports
|May 2, 2022
Summary
A bioprosthetic aortic valve failed in a 74-year-old man. During valve-in-valve replacement, an unusual complication of strut inversion was observed, posing a challenge for the procedure.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Bioprosthetic aortic valve failure necessitates reintervention.
- Transcatheter aortic valve replacement (TAVR) is a common treatment for aortic stenosis.
- Valve-in-valve TAVR offers a less invasive option for patients with prior valve replacement.
Observation:
- A 74-year-old male patient presented with a failing bioprosthetic aortic valve, evidenced by a high mean gradient of 44 mm Hg.
- During a valve-in-valve TAVR procedure, an unexpected complication of lower-end strut inversion of the bioprosthetic valve was identified.
Findings:
- The identified strut inversion represents a rare technical challenge during valve-in-valve TAVR.
- This complication may impact the deployment and sealing of the new valve prosthesis.
Implications:
- Awareness of potential complications like strut inversion is crucial for interventional cardiologists.
- This case highlights the need for careful pre-procedural planning and intra-procedural vigilance in complex TAVR cases.
- Further investigation into the mechanisms and management of strut inversion in TAVR may be warranted.
Related Concept Videos
01:27Mitral Valve Prolapse I: Introduction
55
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
55
01:15Aortic Regurgitation I: Introduction
55
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
55
01:22Mitral Valve Prolapse II: Assessment and Management
49
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
49
01:26Aneurysm III: Interprofessional Care
36
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
36
01:19Mitral Valve Prolapse III: Nursing Management
42
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
42
01:25Aortic Regurgitation III: Medical Management
56
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
56