Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany.
Catheter Cardiovasc Interv. 2019 Jan 1;93(1):174-177. doi: 10.1002/ccd.27858. Epub 2018 Sep 23.
Transcatheter aortic valve replacement (TAVR) is a leading-edge therapy option for patients with severe aortic stenosis (AS) and high surgical risk. However, this minimally invasive procedure is associated with specific complications that may be life-threatening. Valvuloplasty balloon entrapment during postdilatation in transcatheter self-expanding aortic valve stent frames has not yet been a focus of interest in this context. Although it is a rare event, it may critically influence outcome, and different management strategies can be considered. Hereafter, we present the case of a 67-year-old male who underwent transfemoral TAVR and subsequent postdilatation. The valvuloplasty balloon was entrapped in the self-expanding aortic valve stent frame after inadvertent wire passage through the outflow struts. Since surgical risk was high, we preferred a percutaneous approach and extracted the entrapped balloon with high traction force under rapid pacing after valve stabilization with another balloon, which was placed in the annular position.
经导管主动脉瓣置换术(TAVR)是严重主动脉瓣狭窄(AS)和高手术风险患者的前沿治疗选择。然而,这种微创程序与特定的并发症相关,这些并发症可能危及生命。在经导管自膨式主动脉瓣支架框架的后扩张期间,球囊扩张器被卡在其中尚未成为该背景下的关注焦点。尽管这是一种罕见的事件,但它可能会严重影响结果,并且可以考虑不同的管理策略。此后,我们介绍了一位 67 岁男性的病例,他接受了经股 TAVR 和随后的后扩张。在球囊扩张器意外穿过流出道支架后,球囊扩张器被卡在自膨式主动脉瓣支架框架中。由于手术风险很高,我们选择了经皮入路,并在另一个球囊稳定瓣膜后,在快速起搏下以高牵引力将被困的球囊取出,该球囊放置在瓣环位置。