Spectral CT Imaging of Prosthetic Valve Embolization after Transcatheter Aortic Valve Implantation
Tommaso D’Angelo,
Giampiero Vizzari,
Ludovica R. M. Lanzafame,
Federica Pergolizzi,
Silvio Mazziotti,
Michele Gaeta,
Francesco Costa,
Gianluca Di Bella,
Thomas J. Vogl,
Christian Booz,
Antonio Micari,
Alfredo Blandino
Affiliations
Tommaso D’Angelo
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Giampiero Vizzari
Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Ludovica R. M. Lanzafame
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Federica Pergolizzi
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Silvio Mazziotti
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Michele Gaeta
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Francesco Costa
Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Gianluca Di Bella
Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Thomas J. Vogl
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Christian Booz
Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
Antonio Micari
Cardiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Alfredo Blandino
Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124 Messina, Italy
Transcatheter heart valve (THV) embolization is a rare complication of transcatheter aortic valve implantation (TAVI) generally caused by malpositioning, sizing inaccuracies and pacing failures. The consequences are related to the site of embolization, ranging from a silent clinical picture when the device is stably anchored in the descending aorta to potentially fatal outcomes (e.g., obstruction of flow to vital organs, aortic dissection, thrombosis, etc.). Here, we present the case of a 65-year-old severely obese woman affected by severe aortic valve stenosis who underwent TAVI complicated by embolization of the device. The patient underwent spectral CT angiography that allowed for improved image quality by means of virtual monoenergetic reconstructions, permitting optimal pre-procedural planning. She was successfully re-treated with implantation of a second prosthetic valve a few weeks later.
