Cryoextraction for Airway Bleeding After Valve-in-Valve Procedure.

BACKGROUND

Hemoptysis after percutaneous valve implantation is a rare but life-threatening complication.

CASE SUMMARY: An 84-year-old woman with prior mechanical aortic and biological tricuspid valve replacements presented with tricuspid stenosis and regurgitation. A transcatheter valve-in-valve procedure using a 24.5-mm Myval was performed successfully. However, she developed severe hemoptysis, hypoxia, and ventilation difficulties shortly after the procedure. Flexible bronchoscopy with cryoprobe-assisted clot extraction was performed, removing large obstructive clots from the bronchi. A second cryoextraction was necessary 72 hours later. The patient improved rapidly, was extubated, and was discharged in stable condition after 7 days.

DISCUSSION: Cryoextraction is commonly used for tumor-related airway bleeding and foreign body removal, but its application in postvalve implantation hemoptysis is novel. This case highlights its lifesaving role.

TAKE-HOME MESSAGE: Cryoextraction can be a safe and effective alternative when conventional bleeding control methods fail after valve implantation.