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It was reported that on (b)(6) 2026, a 29mm navitor vision valve was selected for implant using a large flexnav delivery system (ds).The patient has a prior medical history of atrial fibrillation.The patient's aortic valve angle was 47 degrees.There was severe annulus calcification extending below annulus into left ventricular outflow tract (lvot).Pre-implant balloon aortic valvuloplasty (pre-bav) was performed by using a 23mm, non-abbott balloon.With a non-abbott wire while pacing at 180 beats per minute.Post pre-bav, the patient went into a complete heart block.During the procedure, ds's inflow edge was passed beyond the annulus then it was attempted to deploy.On the first attempt, it was positioned to be high, so it was recaptured.On the second attempt, the valve was placed at a depth of 4mm both on the non-coronary cusp (ncc) and left-coronary cusp (lcc).Upon release, the valve was at a depth of 3mm on the ncc and 4mm on the lcc.Temporary pacemaker was left in place at the end of the procedure to stabilize the rhythm.Post-implant, mild/moderate paravalvular leak was observed with a gradient of 2mmhg.Post-implant balloon aortic valvuloplasty (post-bav) was performed by using a 25mm, non-abbott balloon.Post-intervention, mild pvl was noted.The patient remained hemodynamically stable throughout the procedure and there was no clinically significant delay reported.A permanent pacemaker was implanted to resolve the event (heart block).The implanter believed the cause of migration to be due to the excess calcium.The implanter classified this event (heart block) as being related to the procedure and past medical history.The patient was in a stable condition and subsequently discharged.
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