{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:47Z","timestamp":1753876247343,"version":"3.41.2"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ventricular septal defect (VSD) is an unusual complication of transcatheter aortic valve implantation (TAVI). The risk factors are not well understood but may include oversizing, calcification amount and location, left-ventricular chamber morphology, and valve-in-valve (ViV) procedures. Percutaneous treatment is challenging but is usually the preferred option.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 80-year-old woman with two previous surgical aortic valve replacements was admitted to our Cardiology Department for decompensated heart failure. New bioprosthesis degeneration (19 mm Mitroflow\u2122, Sorin Group, Canada) was observed with severe intraprosthetic aortic regurgitation. After evaluation, the heart team chose to perform ViV TAVI. Because of the high risk of coronary obstruction, chimney stenting of both coronary arteries was performed. A 23 mm self-expandable Navitor\u2122 valve (Abbott, IL, USA) was implanted, but the Mitroflow\u2122 valve had to be cracked to minimize the persistent high gradient. During valve fracture, the non-compliant balloon broke and a small iatrogenic VSD appeared. However, the patient remained stable, so conservative management was selected. During follow-up, she developed severe haemolytic anaemia and heart failure; therefore, percutaneous closure of the iatrogenic VSD was performed twice, which was a difficult challenge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>A viable alternative to redo surgery is ViV TAVI. Risks include higher rates of prosthesis\u2013patient mismatch and coronary obstruction. Occasionally, bioprosthetic valve fracture is required, particularly in small bioprostheses, to achieve low gradients. Anecdotally, fracture has led to annular rupture and VSD. Most VSDs are small and without clinical or haemodynamic repercussions; however, in symptomatic cases, percutaneous closure is a viable alternative to surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae045","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T21:27:36Z","timestamp":1706909256000},"source":"Crossref","is-referenced-by-count":2,"title":["An unusual complication after transcatheter aortic valve implantation: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-675X","authenticated-orcid":false,"given":"Alba","family":"Abril Molina","sequence":"first","affiliation":[{"name":"Cardiology Department, Juan Ram\u00f3n Jim\u00e9nez University Hospital , Ronda Norte, s\/n , Huelva 21005, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica","family":"Fern\u00e1ndez Quero","sequence":"additional","affiliation":[{"name":"Cardiology Department, Virgen del Roc\u00edo University Hospital , Manuel Siurot, s\/n , Seville 41013, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5522-1332","authenticated-orcid":false,"given":"Jos\u00e9 E","family":"L\u00f3pez Hald\u00f3n","sequence":"additional","affiliation":[{"name":"Cardiology Department, Virgen del Roc\u00edo University Hospital , Manuel Siurot, s\/n , Seville 41013, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Villa Gil Ortega","sequence":"additional","affiliation":[{"name":"Cardiology Department, Virgen del Roc\u00edo University Hospital , Manuel Siurot, s\/n , Seville 41013, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 F","family":"D\u00edaz Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Virgen del Roc\u00edo University Hospital , Manuel Siurot, s\/n , Seville 41013, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"2024022909582500200_ytae045-B1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease: developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"2024022909582500200_ytae045-B2","first-page":"299","article-title":"Valve-in-valve TAVR: state-of-the-art review","volume":"14","author":"Edelman","year":"2019","journal-title":"Innovations"},{"key":"2024022909582500200_ytae045-B3","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/24748706.2018.1434580","article-title":"Ventricular septal defect as a complication 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