Recapture failure in transcatheter aortic valve replacement with CoreValve Evolut R.

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. © 2021 Wiley Periodicals LLC.

Citation

Nobuyasu Ito, Kan Zen, Kensuke Kuwabara, Satoaki Matoba. Recapture failure in transcatheter aortic valve replacement with CoreValve Evolut R. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2021 Sep;98(3):E486-E489

Mesh Tags

PMID: 33645905

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