Abstract
Background
Increasing number of symptomatic patients with severe aortic stenosis is treated with transcatheter aortic valve implantation (TAVI). Stroke is one of the most serious complications of TAVI, and the majority of cerebral events in patients undergoing TAVI have an embolic origin.
Case summary
A 90-year-old female underwent trans-femoral TAVI for symptomatic severe aortic stenosis. Just before the implantation of the transcatheter heart valve (THV), transoesophageal echocardiography (TOE) showed a mobile, high-echoic mass attached to the THV, which gradually enlarged to 26 mm, then spontaneously detached from the THV and flowed up the ascending aorta, disappearing from the TOE field of. After the procedure, the patient presented with ischaemic stroke. The patient’s stroke was thought to have resulted from the embolism migrating to the distal cerebral arteries.
Discussion
The detailed images acquired with TOE during TAVI enabled the prompt identification of the unusual intracardiac mass.
Analysis of Early Out-of Hospital Mortality After Transcatheter Aortic Valve Implantation Among Patients With Aortic Stenosis Successfully Discharged from the Hospital and Alive at 30 Days (from the Placement of Aortic Transcatheter Valves Trial)
