Using a 23-mm self-expanding Portico valve, a 75-year-old woman with significant aortic stenosis underwent transcatheter aortic valve replacement (Abbott). After complete deployment, it was unacceptably low, with significant paravalvular regurgitation. The valve was successfully moved upward to the correct place using the snare motion. The absence of substantial annular calcification during TAVR with self-expanding valves is a risk factor for device malpositioning. Despite the fact that no previous reports exist, our case demonstrates that employing the snare manoeuvre to repair malpositioned Portico valves is both safe and possible. During the single snare movement, the presence of a firm centre wire across the TAVR provides stability.
Udaya Prashant Ponangi
Department of Cardiology, Douglas, Townsville Hospital, Towsnville, Australia.