© 2018 International Journal of the Cardiovascular Academy | Published by Wolters Kluwer - Medknow 32 Abstract Case Report IntroductIon Degenerative aortic stenosis is the most commonly acquired valvular heart disease in adults, with a prevalence of 4% in patients over 80 years of age. In symptomatic patients, surgical aortic valve replacement has been the treatment of choice for 40 years. [1] However, especially for the older ages, up to 30%–60% of cases are considered too high risk for open-heart surgery. [2-4] Transcatheter aortic valve implantation (TAVI) has been introduced in 2002 by Cribier et al. to treat older surgical high-risk patients with severe symptomatic aortic stenosis. [5] The EuroSCORE and Society of Thoracic Surgeons (STS) score are the most widely used risk scores to predict operative mortality in cardiac surgery. [6] caSe report The patient with severe aortic stenosis was hospitalized; after a multidisciplinary discussion by the heart team, the patient was planned for TAVI using the Edwards SAPIEN valve through a transfemoral approach [Figure 1]. When this procedure was administered, the patient was morbidly obese with 40.8 body mass index (BMI). After 5 months, she was admitted to our hospital with severe dyspnea and decreased effort capacity that worsened day by day. Her medical therapy was started immediately and evaluated for the reason. During her examination, echocardiography revealed us a severe aortic regurgitation due to dislocation of the vale to the left ventricular outflow tract. After hemodynamic stability facilitated, she was taken to laboratory and 26 mm CoreValve Evolut R was implanted as valve-in-valve technique [Figures 2 and 3]. No acute complication occurred; after 5-day hospitalization, she was discharged. At the second administration, her BMI was 29.2; she lost 29 kg in 7 weeks, which can be the cause of valve migration. Transcatheter aortic valve implantation (TAVI) is a novel method for patients with severe aortic stenosis at high surgical risk. Although short- and medium-term outcomes after TAVI are encouraging, long-term data on valve function and clinical outcomes are limited. Hence, our case can make a contribution to literature. An 80-year-old patient with severe aortic stenosis underwent TAVI in our clinic in October 2015. After 5 months, she admitted to our emergency department with severe dyspnea. Her symptoms were started within 2 days and getting worse day by day. Echocardiography revealed us a severe aortic regurgitation due to dislocation of the valve to the left ventricular outfow tract side. After diagnosis, aortic regurgitation was treated by valve-in-valve technique. TAVI may provide an alternative therapeutic approach to ineligible or poor surgical candidates of degenerative aortic stenosis. However, this technique also has some complications such as mortality, atrioventricular (AV) block, stroke, and coronary obstruction. Valve embolization is an another rare complication of this procedure and usually can be prevented by careful preprocedure annulus measurements, stable lead positioning for rapid pacing, optimal valve positioning, full balloon infation at the time of valve deployment, and complete balloon defation before stopping rapid pacing. At this point, our case became important for the complication literature with its time, about 5 months. Because it is the more recently used technique, we need much more time to detect the usefulness and complications of TAVI and learn how to avoid these complications. Keywords: Aortic stenosis, transcatheter aortic valve implantation, valve migration Address for correspondence: Dr. Özgen Şafak, Department of Cardiology, Burdur State Hospital, Burdur, Turkey. E‑mail: ozgen_safak@yahoo.com Access this article online Quick Response Code: Website: http://www.ijcva.com DOI: 10.4103/IJCA.IJCA_9_18 This is an open access journal, and artcles are distributed under the terms of the Creatve Commons Atributon-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creatons are licensed under the identcal terms. For reprints contact: reprints@medknow.com How to cite this article: Şafak Ö, Karaca I, Özgüler M. Is it a new late complication of transcatheter aortic valve implantation?. Int J Cardiovasc Acad 2018;4:32-4. Is it a New Late Complication of Transcatheter Aortic Valve Implantation? Özgen Şafak, Ilgın Karaca 1 , Murat Özgüler 2 Department of Cardiology, Burdur State Hospital, Burdur, Departments of 1 Cardiology and 2 Cardiovascular Surgery, Fırat University, Elazığ, Turkey