Related Experiment Video

Updated: Sep 14, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:02

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

186

Subclinical Delayed Coronary Ostial Obstruction After Transcatheter Aortic Valve Replacement With a High-Frame

Paula Ackermann1, Mateo Marin-Cuartas1, A Luise Bayer2

  • 1University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.

JACC. Case Reports
|July 18, 2025
PubMed

Insights

Delayed coronary obstruction can occur after transcatheter aortic valve replacement (TAVR). Endothelial growth around ACURATE neo valves caused this rare complication, emphasizing careful prosthesis selection.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • The ACURATE neo device is a widely used transcatheter heart valve (THV).
  • Long-term complications of THV implantation require ongoing investigation.

Observation:

  • Two patients experienced acute heart failure months after ACURATE neo THV implantation.
  • Exploration revealed massive endothelial overgrowth around the THV, obscuring coronary ostia.
  • This led to subclinical delayed coronary ostial obstruction.

Findings:

  • Endothelial hyperplasia around the ACURATE neo THV can cause delayed coronary obstruction.
  • This complication is rare but serious, particularly in patients with specific aortic anatomies.
  • THV explantation and replacement were necessary to resolve the obstruction.

Implications:

  • Highlights a rare but significant complication associated with the ACURATE neo THV.
  • Underscores the critical importance of careful THV prosthesis selection for individual patient anatomy.
  • Emphasizes the need for optimal implantation techniques to mitigate risks in patients with small aortic roots or low coronary ostia.

Keywords:
biological valve dysfunctioncoronary obstructiontranscatheter aortic valve replacement

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