An Unexpected Free-Floating Aortic Valve Leaflet Avulsion in the Left Atrium on Transesophageal Echocardiography During Transcatheter Aortic Valve Implantation Under Extracorporeal Membrane Oxygenation. | LitMetric
• Aortic valve leaflet avulsion is a rare complication during TAVI. • Avulsed leaflet traveled to the LA with ECMO flow and migrated to the aorta. • TEE aided in timely management and helped complete the transcatheter intervention.
Background: Aortic valve stenosis (AVS) is a progressive disease characterized by fibrosis, inflammation, calcification, and stiffening of the aortic valve leaflets, leading to disrupted blood flow. If untreated, AVS can progress to heart failure and death within 2 to 5 years. Uncovering the molecular mechanisms behind AVS is key for developing effective noninvasive therapies.
Survival into adulthood in patients with an interrupted aortic arch (IAA) is exceedingly rare. A recent literature review found 25 reported cases of IAA in adults. We describe the first case of prolonged, occult, postoperative gastrointestinal bleeding as a major complication following IAA surgery.
Background: Hypoattenuating leaflet thickening (HALT) following transcatheter aortic valve replacement (TAVR) may compromise valve durability, posing a significant barrier to the broader adoption of this technology among younger patients. Self-expanding valves (SEVs) are the most commonly used transcatheter heart valves (THVs) among Chinese patients with aortic stenosis. Understanding the potential mechanisms underlying HALT is, therefore, critical to guide future THV design and development.
Background: The management of Transcatheter Aortic Valve Implantation (TAVI) patients with a small aortic annulus (SAA) postures a substantial challenge, increasing the risk of patient- prosthesis mismatch (PPM) and overall mortality.
Aims: This study aimed to compare the hemodynamic and clinical outcomes of transcatheter balloon-expandable valve (BEV) versus transcatheter self-expandable valve (SEV) in SAA.
Methods: We conducted propensity score matching (PSM) of severe AS patients with SAA who underwent trans-femoral TAVR and enrolled to the Israeli TAVR registry between the years 2008 and 2023.
In patients undergoing transcatheter aortic valve implantation (TAVI), multi-valve disease is common and associated with worse outcomes. Despite multiple emerging transcatheter valve treatment options, no guidelines exist for the transcatheter treatment of multi-valve disease. We present a case of a 76-year-old patient with concomitant severe aortic valve stenosis and severe mitral valve stenosis who underwent concurrent TAVI and transcatheter mitral valve replacement.
