Severe valvular regurgitation and late prosthesis embolization after percutaneous aortic valve implantation

Ann Thorac Surg. 2009 Feb;87(2):618-21. doi: 10.1016/j.athoracsur.2008.06.059.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiography
  • Aortic Valve Insufficiency / etiology*
  • Aortic Valve Insufficiency / surgery
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery*
  • Bioprosthesis
  • Device Removal
  • Disease Progression
  • Echocardiography, Transesophageal
  • Fatal Outcome
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Prosthesis Failure*
  • Reoperation
  • Shock, Cardiogenic / etiology*
  • Shock, Cardiogenic / therapy
  • Thrombosis / etiology*
  • Thrombosis / therapy