A 75-year-old woman with severe aortic stenosis underwent transcatheter aortic valve replacement using a 23-mm self-expanding Portico valve (Abbott). After complete deployment, it was found to be unacceptably low, with significant paravalvular regurgitation. The valve was pulled upward to the correct position successfully by using the snare maneuver. ( Level of Difficulty: Advanced. )

No abstract

Conclusion: This was the first follow-up study of its kind in Timor-Leste, observing the course of echocardiographydetected RHD in a cohort with excellent adherence to secondary prophylaxis. Disease progression was rare, emphasizing the value and potential impact of a successful program of follow up and secondary prophylaxis in similar settings.

Three cases of successful angioplasty of high-grade coronary dissections using hydrophilic wires were reported. Our first case had edge dissection after a stent deployed in the left anterior descending artery, after which we found it impossible to track the second stent over the regular wires, and which was successful when we tried with a stiffer hydrophilic wire. The second had spontaneous coronary artery dissections (SCAD), and the third case was a complicated plaque with multiple stenotic and ectatic segments along with dissection and successful angioplasty carried out using the same wires and without additional hardware. These wires also provided adequate support in tracking the required balloons and stents