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It was reported that on (b)(6) 2026, a 27mm navitor valve was selected for implant using a large flexnav delivery system (ds).Pre-implant balloon aortic valvuloplasty (pre-bav) was performed by using a 24mm, non-abbott balloon.During the procedure, the valve was able to be implanted at a depth of approximately 5mm on the non-coronary cusp (ncc).Post-implant, severe transvalvular aortic regurgitation was observed with a gradient of 7.6mmhg.Transesophageal echocardiography (tee) demonstrated markedly restricted mobility of one of the leaflets, resulting in inadequate leaflet coaptation and impaired hemodynamics presented with low blood pressure and high left ventricle (lv) end-diastolic pressure.Post-implant balloon aortic valvuloplasty (post-bav) was performed by using a 24mm, non-abbott balloon.During post-bav, angiography revealed significant recoil of the valve.Following post-bav, no improvement in leaflet mobility, regurgitation severity, or hemodynamics were observed.While preparing for the second valve, the patient's conditions improved spontaneously with restoration of normal mobility of all three valve leaflets, improved hemodynamics and trace residual paravalvular leak (pvl).Therefore, second valve was not implanted.The user believed the valve expanded non-uniformly because in the right-left (rl) cusp overlap view the expansion appeared to be slightly less than in 3-cusp view.The patient was discharged with no pvl.
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