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12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Severe aortic insufficiency after transapical aortic valve implantation
Hardy Baumbach1, Stephan Hill, Matthias Hansen
1Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany. hardy.baumbach@rbk.de
The Annals of Thoracic Surgery
|August 2, 2011
Summary
A transcatheter aortic valve prosthesis dislocated into the left ventricle two weeks after implantation. Preexisting mitral valve replacement complicated the transcatheter aortic valve implantation procedure.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Devices
Background:
- Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure for aortic valve stenosis.
- Previous cardiac surgery, including mitral valve replacement and coronary artery bypass grafting (CABG), can present unique challenges for TAVI.
- Prosthetic valve dislocation is a rare but serious complication following TAVI.
Observation:
- A patient with a history of mitral valve replacement and CABG underwent uneventful transapical TAVI with an Edwards Sapien aortic valve prosthesis.
- Postoperatively, the patient developed progressive heart failure attributed to severe aortic insufficiency.
- Imaging revealed the dislocated aortic valve prosthesis within the left ventricle.
Findings:
- The dislocated stented aortic valve prosthesis was successfully retrieved and explanted during conventional aortic valve replacement.
- The patient experienced an uncomplicated recovery and was discharged in good condition.
- This case highlights the potential complications associated with TAVI in patients with prior cardiac interventions.
Implications:
- Preexisting mitral valve prostheses may represent a significant complicating factor for transcatheter aortic valve implantation.
- Careful patient selection and procedural planning are crucial in complex cases undergoing TAVI.
- Further research is warranted to understand and mitigate the risks of prosthetic valve dislocation in TAVI patients with prior cardiac surgery.
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