Purpose: To report a successful method of managing an embolized Edwards SAPIEN XT aortic valve prosthesis using a thoracic endovascular aortic repair rescue. Case Report: An 84-year-old man underwent transcatheter aortic valve replacement using a 26-mm Edwards SAPIEN XT valve, which immediately embolized into the ascending aorta. Because of the severe tapering of the patient’s transverse aortic arch, the embolized valve was unable to be maneuvered further down the aorta. Therefore, a Cook 36×80-mm Zenith Dissection Endovascular System (ZDES) bare metal stent was used on a compassionate basis to append the embolized valve between the patient’s coronary artery ostia and the innominate artery takeoff within the ascending aorta, with no neurological or cardiovascular complications at 12-month follow-up. Conclusion: A Cook ZDES bare metal stent may be successfully used to append an embolized Edwards SAPIEN XT valve within the ascending aorta.
NkomoVTGardinJMSkeltonTN. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005–1011.
2.
LeonMBSmithCRMackM. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–1607.
3.
DahdouhZRouleVLognoneT. Aortic annulus rupture during transcatheter aortic valve implantation (TAVI): one ounce of prevention is worth one pound of cure. Heart Lung Circ. 2014;23:e127–e129
4.
MwipatayiBPNairRPapineauJL. A difficult case of retrieval of an aortic valve and balloon during a transcatheter aortic valve implantation. Int J Surg Case Rep. 2013;4:846–848.
5.
TayELGurvitchRWijeysingheN. Outcome of patients after transcatheter aortic valve embolization. JACC Cardiovasc Interv. 2011;4:228–234.
6.
Al AliAMAltweggLHorlickEM. Prevention and management of transcatheter balloon-expandable aortic valve malposition. Catheter Cardiovasc Interv. 2008;72:573–578.
7.
EggebrechtHSchmermundAKahlertP. Emergent cardiac surgery during transcatheter aortic valve implantation (TAVI): a weighted meta-analysis of 9,251 patients from 46 studies. EuroIntervention. 2013;8:1072–1080.
8.
Society of Thoracic Surgeons. Online STS adult cardiac surgery risk calculator. http://riskcalc.sts.org/. Accessed February 2, 2015.
9.
MassonJBKovacJSchulerG. Transcatheter aortic valve implantation: review of the nature, management, and avoidance of procedural complications. JACC Cardiovasc Interv. 2009;2:811–820.
10.
ChakravartyTJilaihawiHDoctorN. Complications after transfemoral transcatheter aortic valve replacement with a balloon-expandable prosthesis: the importance of preventative measures and contingency planning [published online February21, 2013]. Catheter Cardiovasc Interv. doi:10.1002/ccd.24888.
11.
MakkarRRJilaihawiHChakravartyT. Determinants and outcomes of acute transcatheter valve-in-valve therapy or embolization: a study of multiple valve implants in the U.S. PARTNER trial (Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve). J Am Coll Cardiol. 2013;62:418–430.
12.
TuzcuEM. Transcatheter aortic valve replacement malposition and embolization: innovation brings solutions also new challenges. Catheter Cardiovasc Interv. 2008;72:579–580.
13.
GutscheJTCheungATMcGarveyML. Risk factors for perioperative stroke after thoracic endovascular aortic repair. Ann Thorac Surg. 2007;84:1195–1200.
14.
ShahAABarfieldMEAndersenND. Results of thoracic endovascular aortic repair 6 years after United States Food and Drug Administration approval. Ann Thorac Surg. 2012;94:1394–1399.
15.
CarrollMIAhanchiSSKimJH. Endovascular foreign body retrieval. J Vasc Surg. 2013;57:459–463.
