Entrapped Stent Delivery Catheter Shaft After High Risk TAVI: Retrieval & Lessons Learned

Abstract

This case report will discuss a first reported complication of very high coronary occlusion risk related to valve-in-valve (VIV) balloon expandable transcatheter aortic valve replacement (TAVR). As a protective measure, an undeployed coronary stent was placed in the left anterior descending (LAD) artery. During the transcatheter heart valve (THV) deployment, the shaft of the left coronary stent catheter was firmly entrapped between the surgical valve posts and the balloon expandable TAVR frame. This prohibited the retrieval and movement of the coronary stent catheter. There were two subsequent ruptures and detachments of the coronary stent catheter while attempting to retrieve the catheter. This report will provide measures to help avoid this entrapment using VIV/balloon expandable TAVR procedures. Steps taken to successfully manage this complication will be discussed.