Incomplete Expansion of a Self-Expanding TAVR Device Leading to Hemodynamic Collapse

A 78-year-old pleasant male who presented with symptomatic severe aortic valve stenosis underwent transcatheter aortic valve placement. A 34-mm Medtronic evolut pro plus valve was delivered and upon deployment, asystole occurred. The valve was noted to have infolding requiring emergent balloon valvuloplasty and received hemodynamic support. This case highlights the emergence of this complication, methods to prevent occurrence and plans for acute management to include valve expansion and supportive therapies including hemodynamic support.

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All authors: Rajendra P Shah, MBBS; M Zubair Jafar, MD, FSCAI; Benoit R. Bewley, MD; Kamran Haleem, MD; Shalin J. Patel, MD; James Lyons, MD; and Rajeev L Narayan, MD.

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