Two-in-one: A case report of a touchy TAVI procedure with a new valve.
Henri BenkemounPierre BecassisPeter BramlageMarc BeaufigeauPublished in: Journal of cardiac surgery (2021)
Implantation of a second transcatheter heart valve (THV) into a primary THV is a bail-out situation, but may be necessary. An 85-year-old woman was referred with severe symptomatic aortic stenosis (AS). Echocardiography showed a moderately calcified AS. Computed tomography resulted in an average annular diameter of 22.3 mm and an area of 371 mm2 , leading to M-sized ACURATE NEO implantation. Deployment of the upper valve part was uneventful. During lower valve part deployment, the valve dived into the left ventricle outflow tract with the stabilization arches above the annular plane. With the SAFARI guidewire in place, a second M-sized ACURATE NEO was implanted higher inside the first displaced valve. Deployment was straightforward, with no aortic leak, no mitral regurgitation and the patient had normal hemodynamic parameters. Follow-up was uneventful. Positioning a second ACURATE NEO into a failing primary ACURATE NEO is feasible and safe, with favorable short and longer-term outcome.
Keyphrases
- aortic stenosis
- aortic valve
- transcatheter aortic valve replacement
- aortic valve replacement
- left ventricular
- transcatheter aortic valve implantation
- ejection fraction
- mitral valve
- computed tomography
- coronary artery disease
- heart failure
- magnetic resonance
- pulmonary hypertension
- pulmonary artery
- preterm infants
- positron emission tomography
- magnetic resonance imaging
- congenital heart disease
- coronary artery
- pulmonary arterial hypertension
- minimally invasive
- gestational age
- image quality