Statistics

 array:25 [
  "pii" => "S2174204916300691"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2015.09.030"
  "estado" => "S300"
  "fechaPublicacion" => "2016-06-01"
  "aid" => "822"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2016"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Rev Port Cardiol. 2016;35:379.e1-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2211
    "formatos" => array:3 [
      "EPUB" => 153
      "HTML" => 1600
      "PDF" => 458
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:20 [
      "pii" => "S0870255116300713"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2015.09.033"
      "estado" => "S300"
      "fechaPublicacion" => "2016-06-01"
      "aid" => "822"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Rev Port Cardiol. 2016;35:379.e1-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2968
        "formatos" => array:3 [
          "EPUB" => 221
          "HTML" => 2235
          "PDF" => 512
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
        "titulo" => "Aortic embolization of an Edwards SAPIEN prosthesis due to sigmoid left ventricular hypertrophy&#58; Case report"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "379&#46;e1"
            "paginaFinal" => "379&#46;e3"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Emboliza&#231;&#227;o a&#243;rtica da pr&#243;tese Edwards Sapien devida a hipertrofia ventricular esquerda sigm&#243;ide&#58; caso cl&#237;nico"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 925
                "Ancho" => 925
                "Tamanyo" => 66361
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopic image of embolization of the Edwards SAPIEN prosthesis&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Isa &#214;ner Yuksel, Erkan Koklu, Sakir Arslan, Goksel Cagirci, Selcuk Kucukseymen"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Isa &#214;ner"
                "apellidos" => "Yuksel"
              ]
              1 => array:2 [
                "nombre" => "Erkan"
                "apellidos" => "Koklu"
              ]
              2 => array:2 [
                "nombre" => "Sakir"
                "apellidos" => "Arslan"
              ]
              3 => array:2 [
                "nombre" => "Goksel"
                "apellidos" => "Cagirci"
              ]
              4 => array:2 [
                "nombre" => "Selcuk"
                "apellidos" => "Kucukseymen"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204916300691"
          "doi" => "10.1016/j.repce.2015.09.030"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916300691?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116300713?idApp=UINPBA00004E"
      "url" => "/08702551/0000003500000006/v1_201606140033/S0870255116300713/v1_201606140033/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204916300708"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2015.11.029"
    "estado" => "S300"
    "fechaPublicacion" => "2016-06-01"
    "aid" => "823"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2016;35:381-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2077
      "formatos" => array:3 [
        "EPUB" => 134
        "HTML" => 1602
        "PDF" => 341
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "An esophageal lymphoma discovered by echocardiography"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "381"
          "paginaFinal" => "382"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Um linfoma esof&#225;gico descoberto por ecocardiografia"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1167
              "Ancho" => 1346
              "Tamanyo" => 138340
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Top&#58; transthoracic echocardiography&#44; &#40;a&#41; apical 4-chamber view showing a mass to the rear of the left atrium and &#40;b&#41; zoom view on the mass&#59; bottom&#58; computed tomography of the chest&#44; axial view&#44; showing a mass constricting the distal esophagus&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Raffaele Pellecchia, Giordano Zampi, Amedeo Pergolini, Luigi Sommariva"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Raffaele"
              "apellidos" => "Pellecchia"
            ]
            1 => array:2 [
              "nombre" => "Giordano"
              "apellidos" => "Zampi"
            ]
            2 => array:2 [
              "nombre" => "Amedeo"
              "apellidos" => "Pergolini"
            ]
            3 => array:2 [
              "nombre" => "Luigi"
              "apellidos" => "Sommariva"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116300725"
        "doi" => "10.1016/j.repc.2015.11.022"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116300725?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916300708?idApp=UINPBA00004E"
    "url" => "/21742049/0000003500000006/v2_201704050129/S2174204916300708/v2_201704050129/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S217420491630068X"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2015.09.029"
    "estado" => "S300"
    "fechaPublicacion" => "2016-06-01"
    "aid" => "821"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Rev Port Cardiol. 2016;35:377&#46;e1-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3161
      "formatos" => array:3 [
        "EPUB" => 170
        "HTML" => 2544
        "PDF" => 447
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "Heart transplant coronary artery disease&#58; Multimodality approach in percutaneous intervention"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "377&#46;e1"
          "paginaFinal" => "377&#46;e5"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Doen&#231;a coron&#225;ria no transplantado card&#237;aco&#58; abordagem anatomofuncional na interven&#231;&#227;o percut&#226;nea"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1383
              "Ancho" => 1402
              "Tamanyo" => 372801
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Optical coherence tomography&#58; image of the mid left anterior descending artery with lipid-rich atherosclerotic plaque &#40;asterisk&#58; incomplete blood displacement&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Lu&#237;s Leite, V&#237;tor Matos, Lino Gon&#231;alves, Jo&#227;o Silva Marques, Elisabete Jorge, Jo&#227;o Calisto, Manuel Antunes, Mariano Pego"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Leite"
            ]
            1 => array:2 [
              "nombre" => "V&#237;tor"
              "apellidos" => "Matos"
            ]
            2 => array:2 [
              "nombre" => "Lino"
              "apellidos" => "Gon&#231;alves"
            ]
            3 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Silva Marques"
            ]
            4 => array:2 [
              "nombre" => "Elisabete"
              "apellidos" => "Jorge"
            ]
            5 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Calisto"
            ]
            6 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Antunes"
            ]
            7 => array:2 [
              "nombre" => "Mariano"
              "apellidos" => "Pego"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116300701"
        "doi" => "10.1016/j.repc.2015.09.032"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116300701?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491630068X?idApp=UINPBA00004E"
    "url" => "/21742049/0000003500000006/v2_201704050129/S217420491630068X/v2_201704050129/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
    "titulo" => "Aortic embolization of an Edwards SAPIEN prosthesis due to sigmoid left ventricular hypertrophy&#58; Case report"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "379&#46;e1"
        "paginaFinal" => "379&#46;e3"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Isa &#214;ner Yuksel, Erkan Koklu, Sakir Arslan, Goksel Cagirci, Selcuk Kucukseymen"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "Isa &#214;ner"
            "apellidos" => "Yuksel"
            "email" => array:1 [
              0 => "drisayuksel2&#64;hotmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Erkan"
            "apellidos" => "Koklu"
          ]
          2 => array:2 [
            "nombre" => "Sakir"
            "apellidos" => "Arslan"
          ]
          3 => array:2 [
            "nombre" => "Goksel"
            "apellidos" => "Cagirci"
          ]
          4 => array:2 [
            "nombre" => "Selcuk"
            "apellidos" => "Kucukseymen"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Cardiology Department&#44; Antalya Education and Research Hospital&#44; Antalya&#44; Turkey"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Emboliza&#231;&#227;o a&#243;rtica da pr&#243;tese Edwards Sapien devida a hipertrofia ventricular esquerda sigm&#243;ide&#58; caso cl&#237;nico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 925
            "Ancho" => 925
            "Tamanyo" => 66361
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopic image of embolization of the Edwards SAPIEN prosthesis&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Transcatheter aortic valve implantation &#40;TAVI&#41; is emerging as an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis considered to be at high or prohibitive operative risk&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> We report a case of embolization of an Edwards SAPIEN aortic valve due to sigmoid left ventricular hypertrophy&#44; and discuss potential causes and solutions&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 75-year-old woman diagnosed with severe symptomatic aortic stenosis was referred for TAVI&#46; The patient had a history of diabetes&#44; hypertension&#44; coronary artery disease&#44; morbid obesity&#44; and chronic renal failure&#46; Transthoracic echocardiography &#40;TTE&#41; showed sigmoid left ventricular hypertrophy and ejection fraction of 60&#37;&#44; and Doppler echocardiography revealed a mean aortic gradient of 50 mmHg and an aortic valve area of 0&#46;96 cm<span class="elsevierStyleSup">2</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; Transesophageal echocardiography &#40;TEE&#41; carried out for detailed examination revealed sigmoid left ventricular hypertrophy and an aortic annulus diameter of 24 mm&#46; The aortic annulus diameter measured 26 mm&#215;22 mm on multislice computed tomography&#46; The patient was considered to be at too high risk for surgical aortic valve replacement and was referred for TAVI by a transfemoral approach&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The process was performed under deep anesthesia and transthoracic echocardiographic guidance&#46; The TAVI approach was through the right femoral artery using a 26 mm Edwards SAPIEN valve &#40;Edwards Lifesciences&#44; Inc&#46;&#44; CA&#44; USA&#41;&#46; During balloon inflation under rapid pacing the valve prosthesis immediately embolized into the ascending aorta &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46; Attempts to position the valve in the descending aorta were unsuccessful and the bioprosthesis was re-expanded into the aortic arch between the brachiocephalic trunk and the left common carotid artery&#46; At this stage a second Edwards SAPIEN valve was successfully implanted with gradual balloon inflation &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; Arch aortography was carried out which showed no aortic regurgitation and no evidence of obstruction of the left common carotid artery or brachiocephalic trunk&#46; The patient was transferred to the intensive care unit in a hemodynamically stable condition and was discharged one week after the procedure&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">TAVI is a rapidly emerging treatment option for high-risk and inoperable patient groups&#46; However&#44; this new therapeutic modality raises new questions and problems that need to be identified and resolved&#46; Although less invasive than open-chest aortic valve replacement&#44; TAVI is associated with potentially serious complications&#44; such as valve embolization&#46; Valve embolization during TAVI is a life-threatening complication that requires immediate diagnosis and treatment&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Procedural embolization of percutaneously implanted valves has been previously reported&#44; with an incidence of 1&#46;01&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Makkar et al&#46; showed that patients with valve embolization had a greater body surface area and were more likely to be male&#46; A cause for embolization was defined in post-procedural operator reports in 73&#37; of cases&#46; The most commonly stated causes were malpositioning&#44; complex annulus&#47;aortic valve anatomy&#44; and pacing failure&#46; Other causes included post-cardiopulmonary resuscitation&#44; post-dilation&#44; cardiac manipulation&#44; displacement during attempted transcatheter valve-in-valve therapy&#44; poor fluoroscopic angle for implantation&#44; and incomplete&#47;delayed device balloon inflation&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In our case&#44; distal embolization occurred due to sigmoid left ventricular hypertrophy&#44; an example of complex annulus&#47;aortic valve anatomy&#46; In implantation of an aortic valve via a percutaneous route&#44; the key factors for proper placement and fixation are choice of an appropriate size valve&#44; accurate alignment and correct positioning&#46; One of the most important limitations to the use of the Edwards SAPIEN valve system is sigmoid septum&#44; which can lead to embolization of the prosthesis&#46; In patients with pronounced sigmoid septum&#44; apical placement of the Edwards SAPIEN valve or use of a Medtronic CoreValve are recommended&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> However&#44; the presence of severe left ventricular hypertrophy and sigmoid septum are also an important predictor for permanent pacemaker requirement after the use of the CoreValve system&#46; In this case&#44; we preferred to use the Edwards SAPIEN valve because of lack of experience in apical placement and the Medtronic CoreValve system&#46; Outcomes of distal aortic embolization of the Edwards SAPIEN valve remain good&#46; The embolized prosthesis may be repositioned into the aortic arch without need for removal or surgery&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Finally&#44; the precise positioning of the valve&#44; appropriate valve selection&#44; and the route of administration of the procedure appear to be crucial for reducing the risk of valve migration&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Protection of human and animal subjects</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Confidentiality of data</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres824772"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec821232"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres824771"
          "titulo" => "Resumo"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec821231"
          "titulo" => "Palavras chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Case report"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Discussion"
        ]
        7 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conflicts of interest"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-06-26"
    "fechaAceptado" => "2015-09-13"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec821232"
          "palabras" => array:4 [
            0 => "Transcatheter aortic valve implantation"
            1 => "Valve embolization"
            2 => "Edwards SAPIEN"
            3 => "Sigmoid left ventricular hypertrophy"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras chave"
          "identificador" => "xpalclavsec821231"
          "palabras" => array:4 [
            0 => "Implanta&#231;&#227;o percut&#226;nea valvular a&#243;rtica"
            1 => "Emboliza&#231;&#227;o valvular"
            2 => "Edwards SAPIEN"
            3 => "Hipertrofia ventricular esquerda sigm&#243;ide"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transcatheter aortic valve implantation &#40;TAVI&#41; is considered an alternative therapy in high-risk patients with severe aortic stenosis&#46; Although a minimally invasive procedure&#44; it is not free from complications&#44; one of which is valve embolization at the time of TAVI&#46; We present a case of embolization of a balloon-expandable aortic valve due to sigmoid left ventricular hypertrophy and managed with a second valve without surgery&#46; The embolized valve was repositioned in the aortic arch between the left common carotid artery and the brachiocephalic trunk&#46;</p></span>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A implanta&#231;&#227;o percut&#226;nea valvular a&#243;rtica &#40;TAVI&#41; &#233; considerada uma terap&#234;utica alternativa nos doentes de alto risco com estenose a&#243;rtica grave&#46; Apesar de se tratar de um procedimento minimamente invasivo&#44; o mesmo n&#227;o est&#225; livre de complica&#231;&#245;es&#46; Uma das quais &#233; a emboliza&#231;&#227;o valvular no momento da TAVI&#46; Apresentamos um caso de emboliza&#231;&#227;o valvular a&#243;rtica expans&#237;vel por bal&#227;o devido a hipertrofia ventricular esquerda sigmoide tratada com uma segunda v&#225;lvula sem cirurgia&#46; A v&#225;lvula embolizada foi reposicionada na crossa da aorta entre a art&#233;ria car&#243;tida esquerda e o tronco braquiocef&#225;lico&#46;</p></span>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 800
            "Ancho" => 1027
            "Tamanyo" => 112024
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sigmoid left ventricular hypertrophy as observed on transthoracic echocardiography&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 925
            "Ancho" => 925
            "Tamanyo" => 66361
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopic image of embolization of the Edwards SAPIEN prosthesis&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 928
            "Ancho" => 928
            "Tamanyo" => 45097
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopy showing implantation of a second Edwards SAPIEN prosthesis and the embolized valve repositioned in the aortic arch&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;B&#46; Leon"
                            1 => "C&#46;R&#46; Smith"
                            2 => "M&#46; Mack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1008232"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2010"
                        "volumen" => "363"
                        "paginaInicial" => "1597"
                        "paginaFinal" => "1607"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20961243"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determinants and outcomes of acute transcatheter valve-in-valve therapy or embolization&#58; a study of multiple valve implants in the U&#46;S&#46; PARTNER trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;R&#46; Makkar"
                            1 => "H&#46; Jilaihawi"
                            2 => "T&#46; Chakravarty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2013.04.037"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "paginaInicial" => "418"
                        "paginaFinal" => "430"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23684680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High implantation technique during CoreValve replacement in a high-risk aortic stenosis patient with a sigmoid left ventricular hypertrophy and a large aortic annulus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; K&#305;l&#305;&#231;"
                            1 => "E&#46; Ural"
                            2 => "&#350;&#46; Yavuz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Turk Kardiyol Dern Ars"
                        "fecha" => "2015"
                        "volumen" => "43"
                        "paginaInicial" => "275"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25906000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of patients after transcatheter aortic valve embolization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;L&#46; Tay"
                            1 => "R&#46; Gurvitch"
                            2 => "N&#46; Wijeysinghe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2010.10.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2011"
                        "volumen" => "4"
                        "paginaInicial" => "228"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21349463"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A rare complication with Edwards Sapien&#58; aortic valve embolization in TAVI"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Ayhan"
                            1 => "T&#46; Durmaz"
                            2 => "T&#46; Keles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1708538114532923"
                      "Revista" => array:6 [
                        "tituloSerie" => "Vascular"
                        "fecha" => "2015"
                        "volumen" => "23"
                        "paginaInicial" => "102"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24788062"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003500000006/v2_201704050129/S2174204916300691/v2_201704050129/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9919"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000006/v2_201704050129/S2174204916300691/v2_201704050129/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916300691?idApp=UINPBA00004E"
]