Gutter Rotation Technique for Percutaneous Ipsilateral Retrieval of a Ruptured SAPIEN‐3 Balloon

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Publication Details

Journal
Catheterization and Cardiovascular Interventions
Published
2026-09-15
DOI
https://doi.org/10.1002/ccd.70893
Primary Topic
Cardiac Valve Diseases and Treatments
Type
article
Field-Weighted Citation Impact
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article

Gutter Rotation Technique for Percutaneous Ipsilateral Retrieval of a Ruptured SAPIEN‐3 Balloon

Somaraju Bhupatiraju, Anne Venkata Ganeshkumar, Naveen Kumar Murki, Guru Chaithanya Kumar Chagalakondu et al.
Catheterization and Cardiovascular Interventions
Cardiac Valve Diseases and Treatments
article

Gutter Rotation Technique for Percutaneous Ipsilateral Retrieval of a Ruptured SAPIEN‐3 Balloon

Somaraju Bhupatiraju, Anne Venkata Ganeshkumar, Naveen Kumar Murki, Guru Chaithanya Kumar Chagalakondu, Sarat Surapaneni, Siva Sankara Kattinti
article en

Abstract

Balloon rupture during transcatheter aortic valve replacement (TAVR) with balloon-expandable valves is a rare but potentially serious complication that may result in incomplete valve expansion, difficult device retrieval, and vascular injury. We report the case of an 88-year-old woman with severe calcific aortic stenosis who underwent TAVR using a 20-mm SAPIEN 3 transcatheter heart valve. Balloon rupture during valve deployment resulted in partial valve expansion and significant paravalvular leak. Conventional retrieval attempts were unsuccessful because the crumpled balloon became entrapped within the posterior expandable segment ("gutter") of the Edwards E-sheath. A novel Gutter Rotation Technique, involving counter-clockwise rotation of the E-sheath with simultaneous clockwise rotation of the Commander delivery system, redirected the balloon toward the rigid portion of the sheath, enabling successful ipsilateral percutaneous retrieval without surgical or contralateral intervention. Valve expansion was subsequently optimized with balloon post-dilatation. This technique may represent a feasible bailout maneuver in selected cases of Type 1 or Type 2 balloon rupture and warrants further evaluation.

Catheterization and Cardiovascular Interventions
Dayanand Medical College & Hospital (IN), Asha Hospital (IN)
Openalex Percentile: Top 11%
Cardiac Valve Diseases and Treatments
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