Review of Reported Causes of Device Embolization Following Trans-Catheter Aortic Valve Implantation

In this manuscript the authors describe a systematic review of 71 cases of transcatheter heart valve embolization. In 72% of the patients, the prosthesis used was a balloon expandable one. In most cases valve embolization occurred soon after implantation and it happened in the aortic direction. Interestingly, when the access was transapical, the prosthesis more often embolized into the left ventricle. Early embolization was most commonly secondary to device malposition and pacing error. Late embolization was reportedly due to chest compression during cardiopulmonary resuscitation, asymmetric calcification, and low prosthesis implantation. Suggestions are made on how to prevent this complication and how to proceed when it happens.