Author/Editor		Bunc, Matjaž; Vitez, Luka; Terseglav, Simon; Žlahtič, Tadej; Ussia, Gian Paolo
Title		Transcatheter aortic valve dislocation in left ventricular outflow tract with successful repositioning using "double snare" technique
Type		članek
Vol. and No.		Letnik 12, št. 1
Publication year		2021
Volume		str. 7-13
ISSN		2158-284X - International journal of clinical medicine
Language		eng
Abstract		Background: Transcatheter aortic valve implantation (TAVI) is a widely used treatment of severe aortic stenosis. Implantation of a self-expanding valve into a dense calcified aortic annulus can be challenging and may result in de-vice malposition and malfunction. Aim: The aim of our case report is to pre-sent a novel technique of transcatheter aortic valve dislocation treatment. Case presentation: An 86-year-old woman with severely calcified aortic valve underwent TAVI using a 27-mm self-expanding Portico valve (Abbott Vasc, USA). In the last phase of implantation,the valve dislocated deep into the left ventricular outflow tract resulting in significant paravalvular regurgitation and patient instability. Repositioning of the valve with a single snare was in-effective because of severe aortic ring calcifications. A novel %double snare%technique was applied and the valve was successfully repositioned upward with an excellent anatomic and haemodynamic result. Conclusion: %Double snare% technique can be an effective strategy for repositioning of deeply im-planted self-expanding transcatheter aortic valves. It represents an efficient bailout strategy in case of single snare approach failure, especially in cases of severe aortic ring calcifications.
Keywords		aortic valve aortic valve stenosis transcatheter aortic valve replacement aortna zaklopka stenoza aortne zaklopke transkateterska zamenjava aortne zaklopke