Abdelrehim Ahmad, Abdelrahman Ameer, Almagazzachi Ahmad, Desai Harit, Drucker David
Internal Medicine Department, Capital Health Regional Medical Center, Trenton, NJ, USA.
Interventional Cardiology, Capital Health Regional Medical Center, Trenton, NJ, USA.
J Endovasc Ther. 2025 Mar 24:15266028251325656. doi: 10.1177/15266028251325656.
Pacing failure is a common cause of transcatheter aortic valve replacement (TAVR) malposition and embolization. Transcatheter aortic valve embolization that compromises aortic branches usually necessitates open surgery. However, a salvage technique can address this complication percutaneously.
We report a case involving a 26 mm Edwards transcatheter valve that was cephalically embolized during rapid pacing due to ventricular tachycardia with a single capture beat. The semiinflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position.
Carefully pulling back the embolized transcatheter aortic valve (TAV) to the area distal to the left subclavian artery is a viable salvage technique for embolized TAV. Another attempt of TAVR through the embolized valve can be safely performed, with careful monitoring of left ventricular capture during rapid pacing.Clinical Impact Can transcatheter aortic valve (TAV) embolization be solved percutaneously? The semi-inflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position. Carefully pulling back an embolized TAV to the descending aorta is a viable salvage technique for managing embolized TAV.
起搏失败是经导管主动脉瓣置换术（TAVR）位置异常和栓塞的常见原因。经导管主动脉瓣栓塞累及主动脉分支时通常需要进行开胸手术。然而，有一种挽救技术可以经皮解决这一并发症。
我们报告一例病例，一名患者植入一枚26毫米的爱德华兹经导管瓣膜，在因室性心动过速伴单次夺获搏动进行快速起搏期间，该瓣膜向头端栓塞。半膨胀的栓塞瓣膜成功被拉回到左锁骨下动脉远端的位置。随后，通过栓塞的瓣膜植入第二枚26毫米瓣膜，并成功在正确位置展开。
将栓塞的经导管主动脉瓣（TAV）小心地拉回到左锁骨下动脉远端区域是一种可行的TAV栓塞挽救技术。通过栓塞瓣膜进行的另一次TAVR尝试可以在快速起搏期间仔细监测左心室夺获的情况下安全进行。临床影响 经皮能否解决经导管主动脉瓣（TAV）栓塞问题？半膨胀的栓塞瓣膜成功被拉回到左锁骨下动脉远端的位置。随后，通过栓塞的瓣膜植入第二枚26毫米瓣膜，并成功在正确位置展开。将栓塞的TAV小心地拉回到降主动脉是处理TAV栓塞的一种可行挽救技术。
