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A Medtronic Evolut valve embolized during placement. During rapid pacing, a beat occurred and ejected a partially deployed valve. It migrated to the innominate. We retrieved it via sternotomy. A transverse aortotomy was made and the valve easily removed. A new EDWARDS magna surgical valve was implanted and the... show more

Robert Saeid Farivar, MD, PhD

2,332 subscribers

28,021 次观看 • 3 年前 •via X (Twitter)

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9 条评论

Michael O. Kayatta, MD 的头像

Michael O. Kayatta, MD3 年前

Curious how it was partially deployed. The Evolut valve is held by the tabs until the last moment typically.

Robert Saeid Farivar, MD, PhD 的头像

Robert Saeid Farivar, MD, PhD3 年前

The evolut was opened halfway. The pacing failed and a beat occurred. The beat caught the evolut and ejected it.

Lauren Gordon 的头像

Lauren Gordon3 年前

Do you have an angiogram of where it embolized to? What was the concern with the embolization (Eg. Valve rotation/vascular occlusion, unstable position, risk of perforation)? Were there endo options considered? Curious about the decision making for this challenging problem

Robert Saeid Farivar, MD, PhD 的头像

Robert Saeid Farivar, MD, PhD3 年前

The valve embolized to the innominate. The endo options were entertained but abandoned for various reasons. In the hands of a competent surgeon surgery was deemed safest to 1. Implant a new valve and 2. Remove a large deployed valve.

Mahnoosh Foroughi 的头像

Mahnoosh Foroughi3 年前

Greetings Well done where is aortic clamp site, before left carotid?

Robert Saeid Farivar, MD, PhD 的头像

Robert Saeid Farivar, MD, PhD3 年前

Clamp spot was usual proximal to innominate. I had to milk the valve back proximally to clamp.

غَدير 的头像

غَدير3 年前

What is this? Is that Ice 🤔? Why you use it?

Robert Saeid Farivar, MD, PhD 的头像

Robert Saeid Farivar, MD, PhD3 年前

@ghadeerturaiki Ice is used to cool the heart. Standard technique in open heart surgery.

Dr Luis León Hernández Trejo 🇲🇽. 的头像

Dr Luis León Hernández Trejo 🇲🇽.3 年前

Excelente!!!

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