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Ann Thorac Surg 2009;87:618-621. doi:10.1016/j.athoracsur.2008.06.059
© 2009 The Society of Thoracic Surgeons

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Case Reports

Severe Valvular Regurgitation and Late Prosthesis Embolization After Percutaneous Aortic Valve Implantation

Marie-Annick Clavel, DVM, Eric Dumont, MD, Philippe Pibarot, PhD, FACC, Daniel Doyle, MD, Robert De Larochellière, MD, Jacques Villeneuve, MD, Sebastien Bergeron, MD, Christian Couture, MD, Josep Rodés-Cabau, MD, FESC*

Quebec Heart Institute/Laval Hospital, Quebec, Canada

Accepted for publication June 17, 2008.

* Address correspondence to Dr Rodés-Cabau, Quebec Heart Institute/Laval Hospital, 2725 Chemin Ste-Foy, Quebec, G1V 4G5, Canada (Email: josep.rodes{at}crhl.ulaval.ca).

We report the case of a 79-year-old man with low-flow, low-gradient aortic stenosis who underwent transapical aortic valve implantation. The deployment of a 26-mm Edwards SAPIEN valve (Edwards Lifesciences Inc, Irvine, CA) was complicated with the occurrence of severe central aortic regurgitation that was successfully treated with the implantation of a second valve ("valve-in-valve"). Postoperative progress was satisfactory but 2 days after the procedure he suddenly developed cardiogenic shock secondary to the migration of the aortic bioprothesis into the left ventricular outflow tract. Open-heart surgery was undertaken to remove the valves and perform standard aortic valve replacement, but the patient died perioperatively.




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