Author + information
- Received April 24, 2012
- Accepted May 11, 2012
- Published online November 13, 2012.
- Eduardo Franco, MD,
- José Alberto de Agustín, MD, PhD,
- Rosana Hernandez-Antolin, MD, PhD,
- Eulogio Garcia, MD, PhD,
- Jacobo Silva, MD, PhD,
- Luis Maroto, MD, PhD,
- Carmen Olmos, MD,
- Elena Fortuny, MD,
- Dafne Viliani, MD,
- Carlos Macaya, MD, PhD and
- Jose Zamorano, MD, PhD
A 78-year-old woman with symptomatic severe aortic stenosis was referred for transcatheter aortic valve implantation. A 26-mm CoreValve revalving system (Medtronic, Minneapolis, Minnesota) was implanted, but the valve migrated to the ascending aorta (Online Video 1). Afterward, a second 26-mm CoreValve was implanted, but the valve was placed low into the left ventricle outflow tract (A, arrow; Online Videos 2 and 3).
The patient rapidly developed heart failure. An intraprocedural transesophageal echocardiogram revealed a seriously restricted diastolic opening of the anterior mitral leaflet caused by the low-placed CoreValve, leading to severe mitral stenosis with a mean gradient of 13 mm Hg (B to D, prosthesis marked with an asterisk;Online Videos 4, 5, 6, and 7).
The patient underwent urgent aortic valve replacement surgery in which both CoreValves were extracted and a 23-mm Mitroflow bioprosthesis (Sorin Group, Milan, Italy) was implanted, with satisfactory post-operative outcome. AML = anterior mitral leaflet; AO = aorta;GP = pressure gradient; IVT = time-velocity integral; LA = left auricle; LV = left ventricle.
- Received April 24, 2012.
- Accepted May 11, 2012.
- American College of Cardiology Foundation