Novel Bail-Out Strategy for Pigtail Catheter Entrapment During TAVI: A Case Report

Device entrapment during Transcatheter Aortic Valve Implantation (TAVI) is a rare but significant complication, particularly in cases involving calcified aortic anatomy. This case report presents a novel bailout strategy to address pigtail catheter entrapment during a TAVI procedure. An 86-year-old female undergoing TAVI with an Acurate neo2 prosthesis experienced pigtail catheter entrapment between the valve frame and calcified non-coronary cusp during valve deployment. Initial attempts to retrieve the catheter failed, leading to concerns about valve displacement and potential complications. The innovative solution involved inflating a post-dilation balloon within the valve to stabilize the prosthesis while simultaneously retrieving the trapped pigtail catheter. This technique ensured safe extraction without compromising valve integrity or necessitating surgical intervention. The report emphasizes the importance of preemptive measures, including confirming the catheter's free movement and retracting it before final valve release, to prevent similar complications.