Embolization of Left Ventricular Outflow Tract Calcification After TAVR With a Self-Expanding Valve

Le résumé fourni par la source

BACKGROUND: Severe aortic stenosis with extensive left ventricular outflow tract (LVOT) calcification poses challenges during transcatheter aortic valve replacement. CASE SUMMARY: An 85-year-old man with severe aortic stenosis and extensive annular-to-LVOT calcification underwent transcatheter aortic valve replacement with a Navitor system (Abbott). To avoid conduction disturbances, the valve was deployed within the membranous septum under intracardiac echocardiography guidance, using partial recapture and the distal opening technique. Immediately after the procedure, displaced LVOT calcification embolized the left main coronary artery, leading to cardiogenic shock. The patient was successfully treated with emergency percutaneous intervention and was discharged without other embolic events. DISCUSSION: The LVOT calcification, which showed no mobility preoperatively, appeared mobile after the procedure, suggesting that device manipulation may have caused its disruption and embolization. TAKE-HOME MESSAGE: It is important to be aware of the possibility that a partially retracted, slightly opened self-expanding valve may interact with LVOT calcification.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.