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Related Experiment Video

Updated: May 20, 2025

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Rescue and Redeploy: Successful Valve-in-Valve Implantation After Transcatheter Aortic Valve Embolization.

Ahmad Abdelrehim1, Ameer Abdelrahman1, Ahmad Almagazzachi1

  • 1Internal Medicine Department, Capital Health Regional Medical Center, Trenton, NJ, USA.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|March 25, 2025
PubMed
Summary

Transcatheter aortic valve embolization can be successfully managed with a percutaneous salvage technique. This involves repositioning the embolized valve and implanting a second valve through it, avoiding open surgery.

Keywords:
angiographyaortic valveembolized TAV salvagetranscatheter aortic valvetranscatheter aortic valve embolization

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Area of Science:

  • Cardiovascular Interventions
  • Structural Heart Disease
  • Interventional Cardiology

Background:

  • Pacing failure during transcatheter aortic valve replacement (TAVR) can lead to valve malposition and embolization.
  • Embolization of a transcatheter aortic valve (TAV) compromising aortic branches typically requires open surgical conversion.
  • Percutaneous salvage techniques offer an alternative to surgery for TAV embolization complications.

Purpose of the Study:

  • To describe a successful percutaneous salvage technique for a cephalically embolized transcatheter aortic valve.
  • To demonstrate the feasibility of implanting a second TAV through an already embolized valve.

Main Methods:

  • A case report detailing the management of a 26 mm Edwards TAV that embolized during rapid pacing.
  • The embolized, semi-inflated valve was carefully retrieved to a position distal to the left subclavian artery.
  • A second 26 mm TAV was successfully implanted through the retrieved embolized valve.

Main Results:

  • The described salvage technique successfully repositioned the embolized TAV.
  • A second TAV was deployed in the correct position through the retrieved valve.
  • The percutaneous approach avoided the need for open surgery.

Conclusions:

  • Careful retrieval of an embolized TAV to the descending aorta is a viable percutaneous salvage strategy.
  • Performing a second TAVR through an embolized valve is feasible with careful monitoring.
  • This technique provides a crucial alternative for managing TAV embolization during TAVR procedures.