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Transcatheter Aortic Valve Migration During Vascular Access Closure
Jeet J Mehta1, Christopher Scoma1, Bibhu D Mohanty1
1Cardiovascular Disease, University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus
|November 29, 2023
Summary
A novel complication of transcatheter aortic valve replacement (TAVR) involved prosthetic migration. This rare TAVR complication was successfully managed using a second transcatheter prosthesis.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for aortic stenosis.
- Vascular access site management is crucial for TAVR success.
- Standard guidewires are commonly used in TAVR procedures.
Observation:
- A novel complication of TAVR involving prosthetic migration was observed.
- Prosthetic migration occurred due to entanglement with a standard guidewire.
- This event happened during non-large bore vascular access closure.
Findings:
- The prosthetic migration was a previously undescribed mechanism in TAVR.
- Successful bail-out was achieved using a second transcatheter prosthesis.
- Guidewire entanglement poses a risk for TAVR prosthetic migration.
Implications:
- Highlights a rare but serious complication associated with TAVR guidewire use.
- Emphasizes the need for careful guidewire management during vascular access closure in TAVR.
- Suggests potential modifications in guidewire techniques or closure devices to prevent migration.
