Malposition of the Aortic Valve After TAVI with Consequent Severe Aortic Regurgitation
Gordana Milic1 Zorica Mladenovic1,2
1 Clinic of Cardiology, Military Medical Academy, University of Defense, Belgrade, Serbia.
2 School of Medicine, University of Defense, Belgrade, Serbia.
Corresponding Author: Zorica Mladenovic, MD, PhD. Clinic of Cardiology, Military Medical Academy, University of Defense, Belgrade, Serbia. E-mail: zoz3377@gmail.com; Phone: +381 11 266 11 22; ORCID ID: 0000-0002-4668-3922
Pages: Pages: 41-42 / Published online: 9 Jul 2024
Cite this article: Milic G, Mladenovic Z. Malposition of the Aortic Valve After TAVI with Consequent Severe Aortic Regurgitation. Sar Med J. 2024; 1(1): Online ahead of print. 
DOI: 10.70119/0010-24
Original submission: 24 March 2024; Revised submission: 17 June 2024; Accepted: 24 July 2024
Male, 63 years old, with a long-term history of ischemic heart disease. After an myocardial infarction 20 years ago, a surgical evascularization was performed with left interior mammary artery (LIMA) – left anterior descending (LAD) bypass. Elective percutaneous coronary intervention (PCI) with the implantation of one bare metal stent in the circumfl ex artery was done 4 years ago. During this procedure, an indication for transcatheter aortic valve implantation (TAVI) was set due to the progression of stenosis gradient in the bicuspid aortic valve. Immediately after the TAVI procedure, the patient developed symptoms and signs of acute heart failure due to the malposition of the aortic valve and consequent severe aortic regurgitation (AR)(1).
The images depict a transesophageal echocardiographic examination after TAVI (Figure 1-4). Severe AR with paravalvular jets is the result of the malposition of the biological valve after TAVI, where the valve partially occupies the left ventricular outfl ow tract. The inadequately positioned aortic val-ve was surgically removed, followed by the implantation of a mechanical aortic valve. Subsequently, as the patient was dependent on a temporary pacemaker, a permanent dual-chamber pacemaker was implanted. Following the surgical treatment, the patient recovered successfully (2,3).
Consent: The authors have obtained written consent from the patient to submit and publish this case report, including images and accompanying text, in accordance with COPE guidelines.
Conflict of interest: None declared.
Funding: None declared.
