JACC. Case reports · 2025
Use of a Bare Metal Dissection Stent to Manage Aortic Embolization of a Self-Expanding Valve.
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Huber Matthew P, Maitas Oscar L, Elison David M, Zettervall Sara L, Sweet Matthew P, McCabe James M, DeRoo Scott C, Chung Christine J
Аннотация
BACKGROUND: This paper describes a case of prosthesis embolization during transcatheter aortic valve replacement (TAVR) that was managed with a novel percutaneous strategy.
CASE SUMMARY: A 77-year-old man with severe trileaflet aortic valve stenosis underwent TAVR with a 29-mm Evolut FX. The valve embolized to the ascending aorta shortly after its release. TAVR was completed with a 23-mm SAPIEN 3 Ultra RESILIA, and a Zenith Dissection Endovascular Stent was deployed through the embolized Evolut FX, pinning the prosthesis to the aortic wall. The patient experienced no neurologic or aortic injury through 30 days of follow-up.
DISCUSSION: Because of its use in complicated type B aortic dissection, the bare metal dissection stent is an excellent option for managing embolized prostheses that cannot be repositioned in the descending aorta.
TAKE-HOME MESSAGE: Deployment of a bare metal dissection stent may be an important rescue strategy for embolized TAVR prostheses.
CASE SUMMARY: A 77-year-old man with severe trileaflet aortic valve stenosis underwent TAVR with a 29-mm Evolut FX. The valve embolized to the ascending aorta shortly after its release. TAVR was completed with a 23-mm SAPIEN 3 Ultra RESILIA, and a Zenith Dissection Endovascular Stent was deployed through the embolized Evolut FX, pinning the prosthesis to the aortic wall. The patient experienced no neurologic or aortic injury through 30 days of follow-up.
DISCUSSION: Because of its use in complicated type B aortic dissection, the bare metal dissection stent is an excellent option for managing embolized prostheses that cannot be repositioned in the descending aorta.
TAKE-HOME MESSAGE: Deployment of a bare metal dissection stent may be an important rescue strategy for embolized TAVR prostheses.