PMC9503890_01
Perioperative fluoroscopy showing (A) dilation and (B) fully expanded valve.
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F1
Predilation, which was our routine practice at the time, was performed with 25 mm balloon aortic valvuloplasty (Figure 1A). The 29 mm S3 valve was overexpanded an additional 3 mL during deployment to account for the large annulus (Figure 1B).
Transesophageal echocardiography showing (A) chordal rupture and (B) severe mitral regurgitation.
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F2
Wire entrapment in the chordae was not noted before balloon dilation but was likely unrecognized (Figure 2).
Perioperative fluoroscopy showing dilated balloon slipping into the left ventricle; also at https://youtube.com/shorts/Yj-x1ei9OCw.
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V1
The severe mitral regurgitation was subsequently reduced to trivial with a single MitraClip NTR (Abbott) during the same procedure (Figure 3).