Sigmoid Septum and Balloon-Expandable Transcatheter Aortic Valve Replacement: A Cautionary Tale

J Heart Valve Dis. 2015 Jul;24(4):465-7.


Transcatheter aortic valve replacement (TAVR) continues to garner considerable attention, especially as the commercial use of the procedure grows. Herein is highlighted an under-reported, underappreciated challenge in TAVR--that of a sigmoid septum. The two cases reported constitute the first discussion in the contemporary literature of this unique geometry in the setting of TAVR. Specifically, the report addresses how such a bulging septum may preclude safe TAVR with a balloon- expandable prosthesis, and also reinforces the importance of thoroughly evaluating all aspects of the subvalvular anatomy prior to valve deployment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Balloon Valvuloplasty* / adverse effects
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheterization / methods*
  • Cardiomegaly / complications*
  • Cardiomegaly / diagnosis
  • Echocardiography, Transesophageal
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Predictive Value of Tests
  • Prosthesis Design
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Ventricular Septum* / diagnostic imaging