Salvaging lowermost deployment of an acurate device during transcatheter aortic valve replacement with balloon and lasso pull techniques

Catheter Cardiovasc Interv. 2016 Sep;88(3):490-3. doi: 10.1002/ccd.26252. Epub 2015 Oct 1.

Abstract

Transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI), is being used with increasing frequency in patients with severe aortic stenosis at high or prohibitive surgical risk. A number of devices are becoming available for TAVR, and competence in using them is mandatory to maximize the safety and efficacy of TAVR, while individualizing device selection in keeping with patient features. The ACURATE TF is a novel promising device for transfemoral TAVR. However, its peculiar features may require additional maneuvers in case of complications. We hereby report the case of a patient undergoing transfemoral TAVR with the ACURATE TF device, in whom lowermost deployment was complicated by massive aortic regurgitation. With two separate remedial actions, the balloon pull and lasso techniques, we were able to pull back the device and significantly reduce post-TAVR aortic regurgitation. Awareness of this complication and the possible use of these two techniques may increase the safety and efficacy of TAVR with this and other new devices. © 2015 Wiley Periodicals, Inc.

Keywords: aortic stenosis; complication; transcatheter aortic valve implantation; transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / therapy*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / therapy*
  • Balloon Valvuloplasty*
  • Cardiac Catheterization / instrumentation*
  • Cardiac Catheterization / methods
  • Catheterization, Peripheral
  • Femoral Artery / diagnostic imaging
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Prosthesis Design
  • Punctures
  • Radiography, Interventional
  • Severity of Illness Index
  • Treatment Outcome