Rescue Balloon Aortic Valvuloplasty After Sutureless Aortic Valve Replacement for Severe Paravalvular Leak

Nagaoka E, Sato K, Hage A, Bagur R, Harle C, Asopa S, Kiaii B.

Innovations (Phila). 2019 Oct;14(5):476-479.

Abstract

Sutureless aortic valve replacement (AVR) is a wide-spreading new technology that provides short clamping time and excellent hemodynamic outcomes. However, among its possible complications is the risk of paravalvular leak. We present the case of a 63-year-old woman who underwent minimally invasive right mini-thoracotomy AVR) with Perceval S sutureless valve (LivaNova, London, UK). Intraoperative transesophageal echocardiography revealed severe paravalvular leak with stent distortion. Rescue balloon valvuloplasty was performed through the right femoral artery, and resulted in the resolution of the paravalvular leak. This case illustrates the utility and feasibility of balloon valvuloplasty in trouble-shooting sutureless aortic valve stent distortion, thus avoiding a repeat aortic cross-clamp and valve replacement.

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