Bailout From Sinus Jailing: In-Series TAVR-in-TAVR to Avoid Coronary Flow Obstruction

Matteo Casenghi; Omar A Oliva; Mattia Squillace; Michele Bellamoli; Enrico Poletti; Antonio Popolo Rubbio; Luca Testa; Francesco Bedogni; Federico De Marco

doi:10.1016/j.jaccas.2021.02.022

Bailout From Sinus Jailing: In-Series TAVR-in-TAVR to Avoid Coronary Flow Obstruction

JACC Case Rep. 2021 Apr 21;3(4):678-681. doi: 10.1016/j.jaccas.2021.02.022. eCollection 2021 Apr.

Authors

Matteo Casenghi¹, Omar A Oliva¹, Mattia Squillace¹, Michele Bellamoli¹, Enrico Poletti¹, Antonio Popolo Rubbio¹, Luca Testa¹, Francesco Bedogni¹, Federico De Marco¹

Affiliation

¹ Clinical and Interventional Cardiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milan, Italy.

Abstract

Redo transcatheter aortic valve replacement (TAVR) may pose the risk of coronary flow obstruction. We report 2 cases of severe TAVR regurgitation due to different physiopathological mechanisms in which TAVR-in-TAVR could be at high risk for sinus sequestration. Both cases were successfully treated by in-series implantation of a second transcatheter heart valve, thus avoiding sinus sequestration. (Level of Difficulty: Intermediate.).

Keywords: CT, computed tomography; PVL, paravalvular leak; STJ, sinotubular junction; TAVR, transcatheter aortic valve replacement; TAVR-in-TAVR; THV, transcatheter heart valve; coronary obstruction; durability; transcatheter aortic valve replacement.

Publication types

Case Reports