Emergency Valve-in-Valve Transcatheter Aortic Valve Implantation for the Treatment of Acute Stentless Bioprosthetic Aortic Insufficiency and Cardiogenic Shock

Figure 2

(a) Pre-TAVI simultaneous aortic and left ventricular pressures demonstrating equalization of Ao diastolic LV end-diastolic pressures. (b) Post-TAVI hemodynamics revealing normal diastolic LV-Ao gradient and no systolic LV-Ao gradient. (c) Pre-TEE image of the bioprosthetic aortic valve during diastole shows three large regurgitant jets. (d) Post-TEE short axis of the TAVI valve during diastole shows absence of regurgitant flow. (e) Pre-TAVI aortogram shows 4+ aortic insufficiency. (f) Post-TAVI aortogram shows no aortic insufficiency and acceptable implantation depth. TAVI = transcatheter aortic valve replacement; Ao = aortic; LV = left ventricular; TEE = transesophageal echocardiogram.

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