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Balloon-Expandable Transcatheter Heart Valve Dislocation Into the Left Ventricle Successfully Repositioned by an
Mauro Pennacchi1, Melwyn Luis Muthukkattil2, Marco S Nazzaro1
1Department of Cardiology, Interventional Cardiology Unit, San Camillo Hospital, Rome, Italy.
Background:
Transcatheter aortic valve implantation is a well-established treatment option in older patients with symptomatic severe aortic stenosis. Balloon-expandable valve migration is a rare but potentially life-threatening complication.
Case Summary:
We report a case of an 87-year-old man with severe aortic stenosis who underwent transfemoral Edwards Sapien 3 valve implantation complicated by delivery-balloon rupture. During deployment, we observed a pressure drop, resulting in incomplete valve expansion. Acute prosthesis migration into the left ventricle occurred. The prosthesis was crossed with a 28-mm VACS-II balloon (OSYPKA) and successfully repositioned by withdrawing the "anchoring balloon." Angiography showed a well-expanded, well-positioned valve without paravalvular leaks. The patient was discharged 2 days later.
Discussion:
To our knowledge, this is the first case ever reported of successful percutaneous recapturing of a balloon transcatheter heart valve dislocated into the left ventricle during transfemoral transcatheter aortic valve implantation.
Take-Home Message:
Percutaneous recapturing of dislocated balloon-expandable valve into the left ventricle is feasible and may be a valid bailout strategy.
