The first case of "locked-in leaflet" after transcatheter aortic valve replacement in a patient with bicuspid aortic stenosis

Echocardiography. 2018 Jan;35(1):110-113. doi: 10.1111/echo.13756. Epub 2017 Nov 19.

Abstract

This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage. This is the first reported case of bicuspid AS treated with TAVR that eventually resulted in "locked-in leaflet."

Keywords: aortic stenosis; bicuspid aortic valve; locked-in leaflet; multidetector-row computed tomography; transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve / abnormalities*
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / surgery*
  • Bicuspid Aortic Valve Disease
  • Echocardiography, Transesophageal / methods
  • Female
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis*
  • Humans
  • Multidetector Computed Tomography / methods
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / physiopathology
  • Transcatheter Aortic Valve Replacement*