Lotus-in-Evolut R transcatheter aortic valve implantation for severe paravalvular leak.
מילות מפתח
תַקצִיר
Significant paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) is associated with poor outcome. We present the case of an 83-year-old female with severe aortic stenosis who underwent TAVI with an Evolut-R valve (Medtronic, Minneapolis, MN, USA). An aortogram post-procedure showed aortic regurgitation thought to be moderately severe after post-dilatation. She deteriorated 24 h after her procedure and required a further intervention. She was salvaged with a Lotus (Boston Scientific, Marlborough, MA, USA) 'valve in valve' that completely eliminated PVL. <Learning objective: Significant paravalvular leak is a potential complication of transcatheter aortic valve implantation. This can result in poor outcomes especially in patients who have a small non-compliant left ventricular cavity with limited ability to compensate for volume overload. Such complications can be identified early by performing aortography, transthoracic echocardiogram and assessing invasive hemodynamics. A 'valve in valve' procedure with the Lotus valve (Boston Scientific, Marlborough, MA, USA) has shown favorable results in these patients.>.