Attempt at off-label balloon valvuloplasty post-dilation for intuity sutureless valve.

Mejia, Javier; Itagaki, Shinobu; Phillips, Katherine G; El-Eshmawi, Ahmed; Stewart, Allan

Alternatives to traditional aortic valve replacement now form part of the valve surgeon's armamentarium. Sutureless valves offer decreased bypass and crossclamp times, excellent maneuverability, and promising outcomes. We present a case of a sutureless aortic valve replacement for a late failed David procedure, complicated by postoperative development of severe paravalvular regurgitation. We attempted off-label balloon post-dilation to improve expansion of the valve, however paravalvular regurgitation persisted. The patient underwent subsequent aortic valve replacement using a mechanical valve and experienced no further paravalvular leak.