Successful recovery from transcatheter aortic valve embolization by thoracic endovascular stent-graft repair

  • Go Ueno
  • Nobuhisa OhnoEmail author
  • Masanao Toma
  • Taishi Kobayashi
  • Toshi Maeda
  • Otohime Kato
  • Kosuke Yoshizawa
  • Tadashi Miyamoto
  • Keiichi Fujiwara
Case Report


We report a case of an 84-year-old Japanese female patient with transcatheter valve embolization treated with thoracic endovascular stenting. She was diagnosed with severe aortic stenosis and referred to our hospital. Transapical transcatheter aortic valve implantation (TA-TAVI) was selected because she had multiple comorbidities and peripheral vascular disease. During TA-TAVI, the transcatheter valve (TV) came loose and lodged in the distal aortic arch. The TV was floating and unstable, thereby affecting her hemodynamics. After a second TV was placed in the appropriate position with no trouble, we tried fixing the TV using a thoracic endovascular stent-graft. The procedure was successful, and the patient recovered well. The cause of embolization seemed to be associated with a relatively mild calcification of the native aortic valve. Although this complication is rare, several recovery procedures should be prepared.


Transcatheter aortic valve implantation Valve embolization Thoracic endovascular stent-graft repair 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.


  1. 1.
    Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM, et al. 5-Year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015;385:2477–84.CrossRefGoogle Scholar
  2. 2.
    Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609–20.CrossRefGoogle Scholar
  3. 3.
    Seiffert M, Conradi L, Schirmer J, Reichenspurner H, Treedea H, Baldus S, et al. Severe intraprocedural complications after transcatheter aortic valve implantation: calling for a heart team approach. Eur J Cardiothorac Surg. 2013;44:478–84.CrossRefGoogle Scholar
  4. 4.
    Makkar RR, Jilaihawi H, Chakravarty T, Fontana GP, Kapadia S, Babaliaros V, et al. Determinants and outcomes of acute transcatheter valve-in-valve therapy or embolization: a study of multiple valve implants in the U.S. PARTNER trial (Placement of aortic transcatheter valve trial Edwards SAPIEN transcatheter heart valve). J Am Coll Cardiol. 2013;62:418–30.CrossRefGoogle Scholar
  5. 5.
    Mylotte D, Andalib A, Thériault-Lauzier P, Dorfmeister M, Girgis M, Alharbi W, et al. Transcatheter heart valve failure: a systematic review. Eur Heart J. 2015;36:1306–27.CrossRefGoogle Scholar
  6. 6.
    Eggebrecht H, Mehta H, Kahlert P, Schymik G, Lefevre T, Lange R, et al. Emergent cardiac surgery during transcatheter aortic valve implantation (TAVI): insights from the Edwards SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) registry. EuroIntervention. 2014;10:975–81.CrossRefGoogle Scholar
  7. 7.
    Kodali S, Thourani VH, White J, Malaisrie SC, Lim S, Greason KL, et al. Early clinical and echocardiographic outcomes after SAPIEN 3 transcatheter aortic valve replacement in inoperable, high-risk and intermediate-risk patients with aortic stenosis. Eur Heart J. 2016;37:2252–62.CrossRefGoogle Scholar
  8. 8.
    Tay ELW, Gurvitch R, Wijeysinghe N, Nietlispach F, Leipsic J, Wood DA, et al. Outcome of patients after transcatheter aortic valve embolization. JACC Cardiovasc Interv. 2011;4:228–34.CrossRefGoogle Scholar
  9. 9.
    Ussia GP, Barbanti M, Immè S, Scarabelli M, Mulè M, Cammalleri V, et al. Management of implant failure during transcatheter aortic valve implantation. Catheter Cardiovasc Interv. 2010;76:440–9.CrossRefGoogle Scholar
  10. 10.
    Kim WK, Blumenstein J, Liebetrau C, Rolf A, Gaede L, Van Linden A, et al. Comparison of outcomes using balloon-expandable versus self-expanding transcatheter prostheses according to the extent of aortic valve calcification. Clin Res Cardiol. 2017;106:995–1004.CrossRefGoogle Scholar
  11. 11.
    Larion S, Moore JR, Ammar C, Panneton JM. TEVAR rescue of an embolized Edwards SAPIEN XT valve following TAVR. J Endovasc Ther. 2015;22:819–23.CrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryAmagasaki General Medical CenterAmagasakiJapan
  2. 2.Department of CardiologyAmagasaki General Medical CenterAmagasakiJapan
  3. 3.Komyoso ClinicOsakaJapan

Personalised recommendations