CTICasesValve-in-Valve TAVR for Paravalvular Leak
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Imaging findings
Intraoperative imaging and post-operative chest radiographs demonstrate a balloon-expandable Edwards Sapien XT transcatheter heart valve deployed concentrically within a previously placed, self-expanding Medtronic CoreValve. The concentric framing creates an unusual dual-valve appearance on the frontal projection.
Key takeaways
Paravalvular regurgitation is a known complication of transcatheter aortic valve replacement (TAVR), which can occur due to a mismatch between a large aortic annulus and the selected valve size. While some leaks can be addressed using vascular occlusion plugs (such as Amplatzer plugs), performing a transcatheter valve-in-valve deployment by nesting a balloon-expandable valve within the existing self-expanding valve frame is a highly effective salvage option to control severe paravalvular regurgitation.
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