Explantation of a Migrated Self-Expandable Aortic Valve Causing Type A Aortic Dissection: A Case Report

Post-implantation management of embolized transcatheter heart valves (THV) remains controversial. The current practice is to leave an embolized THV in the ascending aorta when it is stable, while implementing a second prosthesis for definitive treatment. We present the case of a 75-year-old male who underwent balloon-expandable aortic valve implantation following the migration of a previously placed self-expandable valve. He presented 1 week later with type A aortic dissection, requiring surgical repair. The argument could be made that even with successful implantation of a second valve, surgical explantation of the migrated valve may be considered in selected cases.