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

 -  2019 
<br/><br/>Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006 
<br/><br/> 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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1522-1946 
<br/><br/><label>Standard No.: </label>10.1002/ccd.27870 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Aortic Valve Insufficiency/et [Etiology]<br/>*Aortic Valve Stenosis/su [Surgery]<br/>*Aortic Valve/su [Surgery]<br/>*Heart Valve Prosthesis<br/>*Prosthesis Failure<br/>*Transcatheter Aortic Valve Replacement/ae [Adverse Effects]<br/>*Transcatheter Aortic Valve Replacement/is [Instrumentation]<br/>Aged<br/>Alloys<br/>Aortic Valve Insufficiency/dg [Diagnostic Imaging]<br/>Aortic Valve Insufficiency/pp [Physiopathology]<br/>Aortic Valve Insufficiency/th [Therapy]<br/>Aortic Valve Stenosis/dg [Diagnostic Imaging]<br/>Aortic Valve Stenosis/pp [Physiopathology]<br/>Aortic Valve/dg [Diagnostic Imaging]<br/>Aortic Valve/pp [Physiopathology]<br/>Balloon Valvuloplasty<br/>Female<br/>Hemodynamics<br/>Humans<br/>Prosthesis Design<br/>Recovery of Function<br/>Severity of Illness Index<br/>Treatment Outcome
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Heart & Vascular Institute
<br/><br/><label>Index Terms--Function: </label><br/>Case Reports