Early Distal Migration of a Self-Expanding Aortic Valve Prosthesis Causing Myocardial Infarction.

Early distal migration after transcatheter aortic valve replacement (TAVR) is a rare but potentially catastrophic complication that presents unique technical challenges for subsequent surgical management. We report a case of early distal migration of a Medtronic CoreValve Evolut R bioprosthesis causing myocardial infarction from coronary ostial obstruction and a practical technique for open surgical device explantation and aortic valve re-replacement. Snaring the stent of the device using standard instruments is a simple but effective method for TAVR explant that allows for optimal positioning of a single aortotomy at the standard anatomic site to facilitate subsequent surgical AVR.