Mind the Gap in TAVR: Recognizing and Managing Misloaded Self-Expanding TAVR Devices

Aninda Omar; Anna Damlin; Andreas Rück; Magnus Settergren; Dinos Verouhis; Rickard Linder; Christopher U Meduri; Nawzad Saleh

doi:10.1016/j.jaccas.2023.102192

Mind the Gap in TAVR: Recognizing and Managing Misloaded Self-Expanding TAVR Devices

JACC Case Rep. 2023 Dec 29;29(3):102192. doi: 10.1016/j.jaccas.2023.102192. eCollection 2024 Feb 7.

Authors

Aninda Omar¹, Anna Damlin^{1

2

3

4}, Andreas Rück^{1

2}, Magnus Settergren^{1

2}, Dinos Verouhis^{1

2}, Rickard Linder^{1

2}, Christopher U Meduri¹, Nawzad Saleh^{1

2}

Affiliations

¹ Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
² Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
³ Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
⁴ Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Abstract

Misloading during transcatheter aortic valve replacement (TAVR) is rare but can cause unpredictable valve release if unrecognized. We describe how to identify a misloaded ACURATE neo2 device, and 3 methods to solve this by using a modified technique of valve deployment, ipsilateral extraction, and contralateral valve externalization with extracorporeal valve release.

Keywords: ACURATE; TAVI; misloading; self-expanding valve.

Publication types

Case Reports