Aorto-Right Ventricular Fistula and Paravalvular Leak After Transcatheter Aortic Valve Implantation

Abstract

Aorto-right ventricular fistula is a potentially fatal complication following transcatheter aortic valve implantation (TAVI). This paper presents a case of successful percutaneous repair of aorto-right ventricular fistula and paravalvular leak after TAVI by using 3D-printed models for pre-procedural planning, and a review of published aorto-right ventricular fistula cases to date. ( Level of Difficulty: Advanced. )

Transcatheter Aortic Valve Replacement Complicated by Aorto–Right Ventricular Fistula Repaired Via Valve-in-Valve Replacement

“…However, this appears to be the first reported case of a fistula repaired using a valve-in-valve approach. 1 …”

Successful percutaneous closure of aortic root-to-right ventricle fistula after transcatheter aortic valve implantation: a valuable option in high-risk surgical patients

“…Percutaneous closure of a TAVI-related ARV fistula represents a technical challenge due to the variability in size, shape and complexity of the defect, and the fact that closure devices could interfere with the TAVI valve itself. So far, very few relevant cases have been described; four using an occluder device, 10–13 one with coil embolization, 14 and one with an Amplatzer Vascular Plug (AVP) vascular plug. 15 In our case, multimodality pre-procedural planning with echocacardiography and 4D cardiac CT allowed detailed assessment of fistula size and anatomy.…”