CTICasesTAVI Malposition with Dual Valve Implantation
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Imaging findings
The TAVI valve was abnormally angulated and in a low position, within the left ventricular outflow tract (LVOT) and extending into the left ventricular (LV) cavity, touching the anterior leaflet of the mitral valve. This resulted in persistent aortic stenosis due to the native valve and secondary mitral stenosis due to restricted mitral leaflet motion. A follow-up CT showed a second Edwards Sapien valve implanted more proximally at the native aortic valve plane, resulting in two Sapien valves.
Key takeaways
This case illustrates a TAVI valve malposition that led to persistent aortic stenosis and induced mitral stenosis. The solution involved a 'valve-in-valve' approach by implanting a second TAVI valve to address the primary aortic stenosis. It highlights the complexities and innovative solutions in managing TAVI complications.
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