Severe paravalvular leakage caused by delayed dislocation of valve prosthesis after transcatheter aortic valve replacement for rheumatic aortic valve disease

RATIONALE: Among patients undergoing transcatheter aortic valve replacement (TAVR), serious perivalvular leakage (PVL) caused by valve dislocation is a rare but serious complication. PATIENT CONCERNS: A 50-year-old male patient was admitted due to chest tightness. DIAGNOSIS: Patient was diagnosed with rheumatic valvular heart disease, aortic stenosis, severe acute insufficiency, acute decompensated heart failure, cardiac function grade IV (New York Heart Association), and multiple organ failure. INTERVENTIONS: After TAVR, delayed left ventricular dislocation of the valve prosthesis caused severe PVL and severe heart failure. A 2nd emergency TAVR operation was performed, and the TAVR artificial valve was implanted again using the transcatheter "valve-in-valve" technique. OUTCOMES: Postoperative evaluation showed mild PVL, and the clinical symptoms were relieved. CONCLUSIONS: Rheumatic aortic valve disease and multiple organ failure, severe PVL caused by delayed dislocation of valve prosthesis after TAVR is rare, which might necessitate prosthetic valve reimplantation using the transcatheter "valve-in-valve" technique.