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Perceval ViV-TAVR: Perception Is Not Always Reality.
Maximilian Reisinger1, Elizabeth James2, Mateusz Kachel1,3
1Division of Cardiac, Thoracic & Vascular Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.
JACC. Case Reports
|September 19, 2024
Summary
Valve-in-valve transcatheter aortic valve replacement is safe for failed Perceval valves but technically challenging. This case highlights a rare complication of wire passage outside the valve frame during the procedure.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- Transcatheter aortic valve replacement (TAVR) is a standard treatment for aortic stenosis.
- Sutureless aortic valves, like the Perceval prosthesis, offer specific advantages in TAVR procedures.
- Valve-in-valve (VIV) TAVR is an established option for managing degenerated bioprosthetic valves.
Observation:
- The Perceval valve is a sutureless bioprosthesis used in TAVR.
- Valve-in-valve TAVR procedures for failed Perceval valves are feasible and safe.
- Technical challenges and potential complications require careful consideration during VIV TAVR.
Findings:
- A case of successful VIV TAVR for a failed Perceval valve is presented.
- The procedure was complicated by inadvertent guidewire passage outside the intended Perceval valve frame.
- Despite the complication, the valve implantation was ultimately successful.
Implications:
- This case underscores the technical complexities associated with VIV TAVR in Perceval prostheses.
- Understanding and anticipating rare complications, such as extra-stent guidewire migration, is crucial for procedural safety.
- Further refinement of techniques may be necessary to mitigate risks in complex VIV TAVR scenarios.
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