Severe Valvular Regurgitation and Late Prosthesis Embolization After Percutaneous Aortic Valve Implantation

• DOI: 10.1016/j.athoracsur.2008.06.059
• Publication Date: 2009-01-20T09:06:36Z
• Authors: Marie-Annick Clavel; Eric Dumont; Philippe Pibarot; Daniel Doyle; Robert De Laroche...; Jacques Villeneuve; Sebastien Bergeron; Christian Couture; Josep Rodés-Cabau
• Keywords: Bioprosthesis; Heart Valve Prosthesis Implantation; Male; Reoperation; Aortic Valve Insufficiency; Angiography; Shock, Cardiogenic; Thrombosis; Aortic Valve Stenosis; Prosthesis Failure; 3. Good health; 03 medical and health sciences; Fatal Outcome; 0302 clinical medicine; Heart Valve Prosthesis; Disease Progression; Humans; Minimally Invasive Surgical Procedures; Device Removal; Echocardiography, Transesophageal; Aged

We report the case of a 79-year-old man with low-flow, low-gradient aortic stenosis who underwent transapical aortic valve implantation. The deployment of a 26-mm Edwards SAPIEN valve (Edwards Lifesciences Inc, Irvine, CA) was complicated with the occurrence of severe central aortic regurgitation that was successfully treated with the implantation of a second valve ("valve-in-valve"). Postoperative progress was satisfactory but 2 days after the procedure he suddenly developed cardiogenic shock secondary to the migration of the aortic bioprothesis into the left ventricular outflow tract. Open-heart surgery was undertaken to remove the valves and perform standard aortic valve replacement, but the patient died perioperatively.