Ballooning an obstructed prosthetic Aortic valve : Can be a real tense procedure!

A 76-year-old woman with a history of double valve replacement (Aortic and mitral valves) for rheumatic heart disease, presented with acute dyspnea after a switch from Warfarin to LMWH before a planned bone marrow biopsy. The investigations revealed a stuck aortic prosthetic valve ,that showed a prohibitive gradient of more than 50 mmhg. Since, she refused further surgery, a rare and risky effort was made to balloon dilate the prosthetic valve leaflet, though it is not a standard approved modality. It was decided to dilate the supero-lateral orifice and the central orifices by simultaneous kissing balloon. The results were dramatic. The images and video are reproduced with courtesy of Dr. David Smith, Dr. Ayush Khurana, Department of Cardiology & Cardiac Surgery, Morriston Cardiac Centre, Swansea Bay University Health Board, Swansea, United Kingdom The stuck valve Twin balloon dilatation of bi-leaflet valve in between the superior and central orifice There are few important lessons from this rare case report. The innovative double balloon catheter Inflation across the the mechanical prosthetic valve is possible. This technique is likely to emerge more useful in the post TAVI population as well.(JSCCAI 2023) Some times, a simple maneuvers like tapping , pushing or releasing stuck leaflet will solve the issue in few lucky patients. The reason is a clot less than 2mm can strategically sit on the hinge point and interfere with its motion...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Mitral prosthetic valve-Surgical tips and techniques prosthetic valve dysfunction prosthetic valves prosthetic valves -Technical issues Uncategorized balloon dilatation of prosthetic valve best review article on prosthetic valve obstruction Source Type: blogs