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This next video,

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I'm gonna go through a case which is an example of device migration.

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In this particular patient while placing the valve,

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they attempted to do a dilation because there was a, a part,

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it was a self-expanding valve and there was a piece of the valve that didn't

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completely expand. And so they went in with a balloon and tried to dilate it in.

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Somehow when they put the balloon in,

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that actually resulted in the valve moving out of position and and migrating.

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What they had to do is then go up with the catheters and retrieve the valve,

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and then they pulled the valve actually closer into the ace aorta into,

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you know what they considered a safe spot below the level of the origins of the

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arch vessels.

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So we can see here as we head down here are the arch vessels in this patient,

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and then here we get into this TAVR device way up high.

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And this is the migrated device, which has been moved into a safe position.

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And then here they went ahead and put in a second valve because obviously the

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first valve wasn't successful,

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so they went ahead again and put in a second valve.

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Now this is not a cardiac aid study, that's why it's a little bit blurry.

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I thought it was a really good example of what can happen with one of these

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valve migrations. I just wanna show you what this looks like on coronal images.

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Here you see on coronal you can see device number one way up

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high.

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So that was the first one that migrated and then was repositioned into a safe

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position of mouse and not how, how sure,

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how far distillate got before the repositioning. But um, nonetheless,

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they put it in the ascending aorta. And then here's the second device,

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which is put in the appropriate location. So not something you see every day.

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This is not a very common complication of tavr, but you know,

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certainly can happen. Very rarely.