A staged approach to transcatheter aortic valve implantation and mitral valve-in-valve implantation for a degenerated bioprosthesis in a high-risk patient.

Abstract

Recently, small case series have described the successful off-label use of transcatheter valve implantation in patients with degenerated bioprosthetic valves in the mitral position. We report here the case of a 78-year old female patient who underwent transcatheter aortic valve implantation for severe aortic stenosis and transapical valve-in-valve implantation for a degenerated mitral bioprosthesis. There was no evidence of intraprosthetic regurgitation and/or paraprosthetic leakages on control angiography and transoesophageal echocardiography. The postoperative course was uneventful. Following accurate patient selection and evaluation by an experienced multidisciplinary team, the transcatheter approach to double-valve implantation in the aortic and mitral positions may represent a viable treatment option for those high-risk patients who would otherwise be inoperable. We preferred a two-step approach, considering a single procedure to be high-risk.

• Authors: Giuseppe Santarpino, Theodor Fischlein, Giovanni Concistrè, Steffen Pfeiffer
• Journal: Interactive cardiovascular and thoracic surgery (Interact Cardiovasc Thorac Surg) Vol. 15 Issue 4 Pg. 764-5 (Oct 2012) ISSN: 1569-9285 [Electronic] England
• PMID: 22753438 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Aortic Valve Stenosis (complications, diagnosis, therapy)
• Bioprosthesis
• Cardiac Catheterization (adverse effects, instrumentation)
• Female
• Heart Valve Prosthesis
• Heart Valve Prosthesis Implantation (adverse effects, instrumentation, methods)
• Humans
• Mitral Valve (diagnostic imaging, surgery)
• Patient Selection
• Prosthesis Design
• Prosthesis Failure
• Radiography
• Risk Factors
• Severity of Illness Index
• Treatment Outcome