Transcatheter Aortic Valve-in-Valve Implantation Complicated by Aorto-Right Ventricular Fistula

Tiffany Patterson; Ronak Rajani; Giulia Esposito; Christopher Allen; Heath Adams; Bernard Prendergast; Christopher Young; Simon Redwood

doi:10.1016/j.jaccas.2019.11.086

Transcatheter Aortic Valve-in-Valve Implantation Complicated by Aorto-Right Ventricular Fistula

JACC Case Rep. 2020 Feb;2(2):309-311. doi: 10.1016/j.jaccas.2019.11.086.

Authors

Tiffany Patterson¹, Ronak Rajani², Giulia Esposito¹, Christopher Allen¹, Heath Adams², Bernard Prendergast², Christopher Young², Simon Redwood¹

Affiliations

¹ Cardiovascular Division, The Rayne Institute British Heart Foundation Centre of Research Excellence, King's College London, St. Thomas' Hospital, London, United Kingdom.
² Cardiothoracic Department, Guy's and St. Thomas' National Health Service Foundation Trust, London, United Kingdom.

Abstract

We describe the case of a degenerative, sutureless bioprosthetic valve (BPV) with deformation and stent infolding in a patient with elevated surgical risk. Following discussion among the heart team, balloon valve fracture was performed to facilitate deployment of an aortic valve-in-valve transcatheter heart valve. Post-procedural imaging demonstrated BPV frame protrusion and contained annular rupture, which required operative intervention. (Level of Difficulty: Intermediate.).

Keywords: AVR, aortic valve replacement; BPV, bioprosthetic heart valve; CT, computed tomography; TAVR; TEE, transesophageal echocardiography; THV, transcatheter heart valve; TTE, transthoracic echocardiography; fistula; sutureless bioprosthesis; valve-in-valve.

Abstract

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