JACC. Case reports · 2026
Balloon Rupture of a Balloon-Expandable Valve in Redo TAVR for Failed Self-Expanding Valve.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Onishi Takayuki, Rao Ajit, Kini Annapoorna S, Granot Yoav, Safi Lucy M, Sharma Samin K, Tang Gilbert H L, Khera Sahil
Аннотация
OBJECTIVE: This study aims to demonstrate a bailout strategy for balloon rupture of the SAPIEN 3 Ultra RESILIA valve during redo transcatheter aortic valve replacement in a calcified, failed Evolut R valve. KEY STEPS: (1) Prompt en bloc removal of the Commander delivery system with the ruptured balloon and 14-F eSheath. (2) Sheath upsizing to 16 F to tamponade potential iliac injury, followed by iliac angiography to confirm the absence of active bleeding. (3) Immediate postdilation of the underexpanded valve to prevent device migration. (4) Endovascular repair of injured iliofemoral arteries using covered stents.
POTENTIAL PITFALLS: Abrupt iliofemoral artery rupture may cause hemorrhagic shock. If significant resistance is encountered during removal, en bloc extraction is aborted and the system is repositioned in the aorta for alternative retrieval (eg, contralateral snaring). If hemorrhagic shock occurs after en bloc removal, covered stents were deployed from the abdominal aorta to the femoral access site. If it occurs before removal is complete, emergent surgical repair is required.
TAKE-HOME MESSAGES: Severe supra-annular leaflet calcification in prior Evolut R valves may predispose to SAPIEN 3 Ultra RESILIA balloon rupture. A successful bailout strategy includes en bloc removal, sheath upsizing, immediate postdilation, and timely endovascular repair.
POTENTIAL PITFALLS: Abrupt iliofemoral artery rupture may cause hemorrhagic shock. If significant resistance is encountered during removal, en bloc extraction is aborted and the system is repositioned in the aorta for alternative retrieval (eg, contralateral snaring). If hemorrhagic shock occurs after en bloc removal, covered stents were deployed from the abdominal aorta to the femoral access site. If it occurs before removal is complete, emergent surgical repair is required.
TAKE-HOME MESSAGES: Severe supra-annular leaflet calcification in prior Evolut R valves may predispose to SAPIEN 3 Ultra RESILIA balloon rupture. A successful bailout strategy includes en bloc removal, sheath upsizing, immediate postdilation, and timely endovascular repair.