TEVAR Rescue of an Embolized Edwards SAPIEN XT Valve Following TAVR

J Endovasc Ther. 2015 Oct;22(5):819-23. doi: 10.1177/1526602815599163. Epub 2015 Aug 5.

Abstract

Purpose: To report a successful method of managing an embolized Edwards SAPIEN XT aortic valve prosthesis using a thoracic endovascular aortic repair rescue.

Case report: An 84-year-old man underwent transcatheter aortic valve replacement using a 26-mm Edwards SAPIEN XT valve, which immediately embolized into the ascending aorta. Because of the severe tapering of the patient's transverse aortic arch, the embolized valve was unable to be maneuvered further down the aorta. Therefore, a Cook 36×80-mm Zenith Dissection Endovascular System (ZDES) bare metal stent was used on a compassionate basis to append the embolized valve between the patient's coronary artery ostia and the innominate artery takeoff within the ascending aorta, with no neurological or cardiovascular complications at 12-month follow-up.

Conclusion: A Cook ZDES bare metal stent may be successfully used to append an embolized Edwards SAPIEN XT valve within the ascending aorta.

Keywords: aortic valve; bare metal stent; device embolization; prosthetic valve; thoracic dissection stent; thoracic endovascular aortic repair; transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aorta, Thoracic* / diagnostic imaging
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Aortography / methods
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Compassionate Use Trials
  • Embolism / diagnosis
  • Embolism / etiology
  • Embolism / therapy*
  • Endovascular Procedures* / instrumentation
  • Foreign-Body Migration / diagnosis
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / therapy*
  • Heart Valve Prosthesis / adverse effects*
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / instrumentation
  • Humans
  • Male
  • Metals
  • Prosthesis Design
  • Stents
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Metals