Related Experiment Video

Updated: Aug 21, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.7K

Bail out lithotripsy to treat delayed valve-in-valve TAVR-related coronary obstruction

Brian O Bingen1, Ibtihal Al Amri1, Jose M Montero-Cabezas1

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 17, 2022
PubMed

Insights

Delayed coronary artery obstruction after transcatheter aortic valve replacement is challenging. Intravascular lithotripsy and multiple stents successfully treated stent compression caused by a calcified aortic valve leaflet.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Valve-in-valve (ViV) TAVR procedures can present unique complications.
  • Delayed coronary artery obstruction (CAO) is a rare but serious complication after ViV TAVR.

Observation:

  • Coronary access and stent compression by the native aortic valve leaflet impede treatment.
  • A case of delayed CAO occurred after Edwards Sapien 3 in St. Jude Trifecta VIV TAVR.
  • The obstruction was caused by stent compression from the calcified native aortic valve leaflet.

Findings:

  • Percutaneous treatment was challenging due to anatomical constraints.
  • Intravascular lithotripsy was used to modify the calcified leaflet.
  • Successful treatment was achieved with multistenting to restore coronary flow.

Implications:

  • This case demonstrates a novel approach to managing complex post-TAVR CAO.
  • Intravascular lithotripsy offers a potential solution for stent compression in VIV TAVR.
  • Multistenting can overcome leaflet-induced stent compression, improving outcomes.

Keywords:
aortic valve diseasecoronary artery diseaseinterventional devices/innovationpercutaneous coronary interventionstenting technique

More Related Videos

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction06:57

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

14.8K
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.6K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
16
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
25
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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...
32
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
27
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
69
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
22