Successful Treatment of Severe Paravalvular Leak by Repositioning a Self-Expandable Percutaneous Aortic Valve Bioprosthesis (Evolut PRO+) Using the “Double Snare” Technique

Figure 5

Transesophageal echocardiogram. (a) Aortic bioprosthesis ventricular migration (solid arrow) causing severe PVL (Videos 1–3) by color Doppler (dashed arrow). (b) Transgastric view showing a large vena contracta (0.636 cm). PVL circumferential extent (arrow) involving ~50% of the aortic annulus in the short-axis views in (c) 2D and (d) 3D color Doppler. (e) Thoracic aorta holodiastolic flow reversal consistent with severe PVL (arrow).

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