Open Access 29-03-2024 | Transthoracic Echocardiography | Images in Cardiovascular Intervention
Acute leaflet malfunction of Navitor valve with severe intraprosthetic aortic insufficiency immediately after implantation
Published in: Cardiovascular Intervention and Therapeutics
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An 85-year-old female was admitted our hospital due to congestive heart failure secondary to very severe aortic stenosis. Preoperative computed tomography (CT) demonstrated severe leaflet calcification and anatomical measurements confirmed suitability for transcatheter aortic valve (TAV) implantation (Fig. 1A–E), using a 25 mm Navitor (Abbott, Abbott Park, IL, USA). After pre-dilatation with an 18 mm balloon, a 25 mm Navitor was deployed. The Implantation depth was acceptable and transthoracic echocardiography (TTE) revealed mild paravalvular leakage (PVL) at the point of no recapture (Fig. 1F and G).
Fig. 1
A–E Preoperative CT measurement match to 25 mm Navitor. A Aortic annulus, B sinus of Valsalva, C sinotubular junction, D, E left/right coronary heights. F Implantation depth was about 4 mm in fluoroscopy. G TTE revealed mild PVL at point of no recapture. H, I Acute severe intraprosthetic insufficiency occurred and required inotropes to maintain blood pressure. J TTE short axis view of diastolic phase showed regurgitant orifice at non coronary cusp (NCC) site. K Schema of TTE short axis view. L, M RAO Caudal and RAO Cranial view revealed under-expansion of Navitor at NCC site. N, O After post dilatation with 20 mm balloon, regurgitation became worse. P 20 mm S3UR in 25 mm Navitor was performed under left coronary protection. Q TTE showed no PVL and optimal prosthetic function
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