Percutaneous Repair of Left Ventricular Wire Perforation Complicating Transcatheter Aortic Valve Replacement for Aortic Regurgitation.

A 74-year-old woman with severe aortic regurgitation, moderate mitral regurgitation, coronary artery disease status post bypass with left internal mammary artery to the left anterior descending coronary artery, and severe emphysema was deemed inoperable for open aortic valve replacement and underwent elective transcatheter aortic valve replacement. Because of the lack of annular calcium, the recapturable 29-mm Evolut R (Medtronic, Minneapolis, Minnesota) was chosen. We had considerable difficulty landing the valve because of movement from the aortic regurgitation without calcium in the annulus. After release, the valve migrated considerably into the left ventricle, with a mild