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It was reported that on (b)(6) 2026, a 25mm navitor vision valve was selected for implant using a large flexnav delivery system (ds).The patient did not have a history of right bundle branch block (rbbb), left bundle branch block (lbbb) and 1st/2nd atrioventricular block (av) block.The patient has a severely calcified leaflets with calcification extending in the left ventricular outflow tract (lvot).The patient's aortic valve angle was 52 degrees.Pre-implant balloon aortic valvuloplasty (pre-bav) was performed by using a 20mm, non-abbott balloon.During the procedure, while advancement of the flexnav ds across the annulus, the patient developed with a complete atrioventricular (av) block.A temporary pacemaker was placed to stabilize the cardiac rhythm.At 80 percent deployment, an incomplete stent opening (iso) was observed then the valve was recaptured.On the second attempt, the valve was placed at a depth of 4mm on the non-coronary cusp (ncc), iso remained unchanged; however, it was full deployed in the native annulus at a depth of 4mm on the non-coronary cusp (ncc) and iso was observed to be less than prior to deployment.Post-implant balloon aortic valvuloplasty (post-bav) was performed by using a 22mm, non-abbott balloon to address the iso.During post-bav, the valve migrated towards the aorta to a depth of 0mm on the ncc.Permanent pacemaker was implanted to resolve the heart block; no additional intervention was performed for the migration.The patient remained hemodynamically stable throughout the procedure and there was no clinically significant delay reported.Post-procedure on an unknown date, the patient was developed with stroke and presented with loss of sensation in the left extremity.The patient had recovered from the neurological symptoms; however, the patient had an extended hospitalization.
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