Percutaneous Valvular Closure Followed by TAV-in-TAV Intervention during a Single Procedure in order to Treat a Severe Paravalvular Leak after Performing TAVI in a Bicuspid Aortic Stenosis

Figure 3

(a) Fluoroscopy with complete deployment of the two Amplatzer plugs. (b) A PVL was caused by the aortic prosthesis being set too low and its poor apposition against the heavily calcified commissure of the native aortic valve. A Terumo wire was pushed through the Evolut R valve’s struts and then two SVD Amplatzer plugs were implanted. Due to persistent PVL after plug implantation, a further TAV-in-TAV intervention was performed. PVL: paravalvular leak; TAV: transcatheter aortic valve.

(a)

(b)