Snare-assisted bailout of an embolized Evolut FX transcatheter aortic valve replacement prosthesis using a valve-through-valve balloon-expandable implantation.

Transcatheter aortic valve replacement (TAVR) is now the standard of care for severe symptomatic aortic stenosis; however, rare procedural complications such as valve embolization can result in life-threatening consequences. We describe a case of intraprocedural embolization of a self-expanding Medtronic Evolut FX valve into the ascending aorta during deployment. The embolized prosthesis was stabilized with a snare and parked distal to the sinotubular junction. Because a second self-expanding valve could not be advanced across the displaced frame, a 23 mm balloon-expandable Edwards SAPIEN 3 Ultra RESILIA valve was successfully delivered through the embolized prosthesis and deployed in the native annulus. This cross-platform valve-through-valve bailout restored durable valve function without surgery and underscores the importance of procedural adaptability in managing complex TAVR complications.