Patient presented for an elective transfemoral aortic valve replacement (tavr).Past medical history includes severe aortic stenosis and right common and external iliac artery stenting.Access was initiated in the right femoral artery under ultrasound and angiography.The valve was positioned and deployed, however the ventricular side of the valve did not dilate appropriately.The partially deployed valve was pulled distally beyond the aortic valve and into the aorta.It was then determined the right iliac stent was found on the ventricular end of the tavr valve, restricting from deployment.The tavr and iliac stent were pulled back beyond the arch vessels in the transverse to descending aorta as the valve balloon would not come off of the stent.A successful attempt followed in dislodging the tavr balloon from the valve.Attempts to then fracture the stent were unsuccessful.Attempts to snare and separate the stent from the valve were not successful.The procedure was then concluded.Surgical intervention for removal of the valve and stent is required.A second tavr procedure was performed successfully 5 days later.Further intervention for retained valve/stent is under evaluation.
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