Abstract
BACKGROUND: Balloon entrapment during transcatheter aortic valve replacement (TAVR) is a rare but serious complication, especially in patients with severe valve calcification. CASE SUMMARY: A 78-year-old woman with symptomatic severe aortic stenosis (peak velocity 7.23 m/s, preserved left ventricular ejection fraction 70%) underwent TAVR. After valve deployment, the balloon became entrapped within the prosthesis. Controlled postdilation was performed to disrupt the valve frame mesh, successfully releasing the balloon. The patient recovered well; at nearly 3 years of follow-up, she remains asymptomatic without rehospitalization for heart failure or neurologic events. DISCUSSION: This case highlights the role of controlled postdilation as a safe and effective bailout strategy for balloon entrapment during TAVR. Reviewing the literature, balloon entrapment is rare but potentially life-threatening, and prompt recognition with appropriate technical solutions is critical for favorable outcomes. TAKE-HOME MESSAGES: Balloon entrapment during TAVR is rare but can be effectively managed with controlled postdilation, particularly in patients with severe calcification. Ensuring correct guidewire position in the left ventricle, confirmed by multiple fluoroscopic views, helps prevent balloon entrapment by avoiding passage through the stent mesh.