Dislocation and Snaring of an Aortic Bifurcation Stent During Transfemoral Aortic Valve Replacement-a Case Report.

Abstract

Transfemoral aortic valve replacement (TAVR) is an effective way to treat severe aortic valve stenosis, especially in patients who are high-risk for surgery. Dislocation of an endoluminal aortic bifurcation stent graft during TAVR is an extremely rare complication. We present a case on how management of this complication was successfully done. An 86-year-old man presented at the ER after syncope. He was admitted to the cardiology department for further examinations. Transthoracic echocardiography (TTE) revealed severe aortic stenosis. Other comorbidities included endovascular stent graft repair due to an infrarenal abdominal penetrating aortic ulcer. During the following TAVR procedure dislocation of the endoluminal stent graft was observed. Using a snare loop this foreign material was fixated in the right common iliac artery. The patient was hemodynamically stable and endoluminal aortic valve replacement could successfully commence. After implantation of aortic valve bioprothesis, the foreign material was retrieved from the right femoral artery. The patient remained asymptomatic and stable postprocedural. Dislocation of an endoluminal stent graft during TAVR remains a rare complication. This complication can arise due to several factors, including patient-specific anatomical challenges and procedural complexities. Decisions are based on the individual patient but are also made in consensus with the interventional cardiologist' team.