Retrieval of Ruptured Valves and Their Accessories During Transcatheter Aortic Valve Replacement

Abstract

Transcatheter aortic valve replacement (TAVR) is a safe alternative to surgery in patients with severe aortic stenosis. We report a case of balloon rupture during TAVR with successful retrieval of its remnant and review this complication and its management.

Intraventricular entrapment of a Sapien‐3 balloon in transapical TAVR: A near missed catastrophe

“…To the best of our knowledge, this is the first case of SAPIEN‐3 delivery system rupture and intraventricular entrapment of the fractured equipment during TA‐TAVR. Opposite to the above‐mentioned cases, 2‐7 preoperative CT scan (Figure 1) did not show any significant calcified bulky mass, which could have caused balloon rupture. The nose cone did not severed from the wire lumen, avoiding the risk of distal embolization.…”

“…Balloon rupture and device fracture can be related to severe calcified aortic root, balloon oversizing and inflation pressure higher than burst pressure 2 . In 2011, the Food and Drug Administration warned about balloon rupture and SAPIEN Retroflex3 nose cone separation during a TF‐TAVR 3 .…”

“…reported a SAPIEN balloon rupture at the time of maximal inflation during TF‐TAVR. The under‐expansion of the stent caused significant paravalvular leak requiring post‐dilatation 2 . Several authors reported circumferential balloon rupture during TF‐TAVR with both SAPIEN 4 and SAPIEN‐XT 5 and during both TF‐TAVR 6 and transaortic‐TAVR 7 with SAPIEN‐3.…”

“…Balloon rupture is a rare adverse event of transcatheter aortic valve replacement (TAVR) 1,2 . It is seldom reported in the literature, though no reports exist on balloon disruption and tearing with an intraventricular entrapment during a transapical (TA)‐TAVR.…”