Recapture failure in transcatheter aortic valve replacement with CoreValve Evolut R

Autor: Satoaki Matoba, Kan Zen, Kensuke Kuwabara, Nobuyasu Ito
Rok vydání: 2021
Předmět:
Zdroj: Catheterization and Cardiovascular Interventions. 98
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.29580
Popis: Self-expanding prostheses for transcatheter aortic valve replacement (TAVR), which can be recaptured, provide us the option of repositioning for a more accurate placement. We report a very rare case in which the recapture of CoreValve Evolut R (Medtronic, Minneapolis, Minnesota) to correct the implantation depth during the deployment could not be achieved. We planned TAVR with a 23 mm Evolut R prosthesis for a 92-year-old female with severe aortic stenosis and tightly bent thoracic aorta. During the first deployment attempt, the implantation depth was greater than we expected at 2/3 deployment. They tried to recapture and reposition the prosthesis, but the prosthesis was not re-sheathed into the capsule of the delivery system. The prosthesis could not be recaptured despite a repeat attempt, and they were forced to deploy the device as it was. The prosthesis was deployed very carefully and implanted successfully without a pop-up into the ascending aorta. At a later date, this situation was replicated in vitro and was found that the distal segment of the capsule became deformed, increasing the resistance to rotating the grip handle.
Databáze: OpenAIRE