A word of caution using self-expanding transcatheter aortic valve-frame infolding.

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 93(3):555-558, 2019 02 15.PMID: 30378244Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: *Aortic Valve Insufficiency/et [Etiology] | *Aortic Valve Stenosis/su [Surgery] | *Aortic Valve/su [Surgery] | *Heart Valve Prosthesis | *Prosthesis Failure | *Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | *Transcatheter Aortic Valve Replacement/is [Instrumentation] | Aged | Alloys | Aortic Valve Insufficiency/dg [Diagnostic Imaging] | Aortic Valve Insufficiency/pp [Physiopathology] | Aortic Valve Insufficiency/th [Therapy] | Aortic Valve Stenosis/dg [Diagnostic Imaging] | Aortic Valve Stenosis/pp [Physiopathology] | Aortic Valve/dg [Diagnostic Imaging] | Aortic Valve/pp [Physiopathology] | Balloon Valvuloplasty | Female | Hemodynamics | Humans | Prosthesis Design | Recovery of Function | Severity of Illness Index | Treatment OutcomeYear: 2019Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-1946
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: Copyright (c) 2018 Wiley Periodicals, Inc.Transcatheter aortic valve replacement has become a mainstay alternative to surgical aortic valve replacement in patients with severe aortic stenosis at high and intermediate surgical risk. Two commercially approved valves are available in the United States: balloon-expandable and self-expanding. We report here a rare complication of a self-expanding Evolut PRO (Medtronic, Minneapolis, Minnesota) valve failing to expand due to nitinol frame infolding. This results in a malopposed valve with a severe paravalvular leak, even though treated successfully with balloon valvuloplasty. It is important to recognize the characteristic angiographic signature of this complication-the "straight line" sign-and how to avoid this potentially serious complication by balloon valvuloplasty or by recapture and deployment of a new valve.All authors: Ben-Dor I, Rogers T, Satler LF, Waksman ROriginally published: Catheterization & Cardiovascular Interventions. 2018 Oct 30Fiscal year: FY2019Digital Object Identifier: ORCID: Date added to catalog: 2018-11-09
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30378244 Available 30378244

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

Copyright (c) 2018 Wiley Periodicals, Inc.

Transcatheter aortic valve replacement has become a mainstay alternative to surgical aortic valve replacement in patients with severe aortic stenosis at high and intermediate surgical risk. Two commercially approved valves are available in the United States: balloon-expandable and self-expanding. We report here a rare complication of a self-expanding Evolut PRO (Medtronic, Minneapolis, Minnesota) valve failing to expand due to nitinol frame infolding. This results in a malopposed valve with a severe paravalvular leak, even though treated successfully with balloon valvuloplasty. It is important to recognize the characteristic angiographic signature of this complication-the "straight line" sign-and how to avoid this potentially serious complication by balloon valvuloplasty or by recapture and deployment of a new valve.

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