Replacement of a Dislocated Aortic Prosthesis After Transcatheter Valve Implantation.

Abstract

A 77-year-old woman who had severe symptomatic aortic stenosis and was a high risk for conventional surgery underwent transcatheter aortic valve implantation by means of the transfemoral approach. The prosthesis migrated and became embolized in the left ventricle after inflation, causing interference with the mitral valve and also partial outflow tract obstruction. The patient was emergently transferred to the operating room. Vertical aortotomy was performed under cardiopulmonary bypass, and the calcified native leaflets were removed. The migrated Edwards SAPIEN XT valve was extracted and subsequently successfully sewn into the annulus after examination for leaflet and stent competence. The hemodynamic performance of the implanted valve was surprisingly more favorable than that of the conventional tissue prosthesis.