Transcatheter Treatment of Pure Aortic Regurgitation in a Horizontal Aorta Complicated by Valve Embolization and Aortic Dissection

Cardiovasc Revasc Med. 2019 Jun;20(6):535-536. doi: 10.1016/j.carrev.2018.12.013. Epub 2018 Dec 15.

Abstract

A 83-year-old female with severe aortic regurgitation (AR) and an horizontal ascending aorta was scheduled for a transcatheter aortic valve replacement. After the complete deployment, a Portico 29 mm valve embolized in the ascending aorta due to the unfavorable anatomy of the anchoring zone. A second Portico 29 mm was successfully implanted using the embolized valve for superior anchoring. The patient died 7 days after the procedure due to a retrograde aortic dissection. This case shows a rare but possible complication that occurs especially in unfavorable and complex aortic anatomies.

Keywords: Aortic dehiscence; Aortic dissection; Aortic regurgitation; Bicuspid aortic valve; Pure aortic regurgitation; Transcatheter aortic valve implantation; Valve embolization.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged, 80 and over
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / etiology*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / etiology*
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery*
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / surgery*
  • Fatal Outcome
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology*
  • Heart Valve Prosthesis*
  • Hemodynamics
  • Humans
  • Prosthesis Design
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / instrumentation*
  • Treatment Outcome