Mechanical thrombectomy of embolised native aortic valve post-TAVI

Description

A man aged 80 years with severe aortic stenosis underwent transcatheter aortic valve implantation (TAVI).

TAVI was performed using a 29 mm Edwards Sapien III valve. The valve was implanted directly, without predilation.

Immediately postvalve deployment, the patient became hypertensive and developed right-sided hemiplegia and aphasia.

The Prostar femoral closure device was used to close the femoral access site and the patient had an immediate CT brain, CT cerebral angiogram and stroke team consult.

CT cerebral angiogram demonstrated near total occlusion of the M2 segment of the left middle cerebral artery (figure 1).

Figure 1

CT cerebral angiogram demonstrating near total occlusion of the M2 segment of the left middle cerebral artery (arrowed).

His National Institute of Health Stroke Score (NIHSS) was 19 indicating a severe stroke.

Our patient proceeded to mechanical thrombectomy for his left middle cerebral artery infarction.

Thrombolysis...

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