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Published on: July 18, 2014
Prominent septal hypertrophy: a contra-indication for transapical aortic valve implantation?
Darrin M Payne1, Josep Rodes-Cabau, Daniel Doyle
1Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada.
Abstract:
We report a case of transapical aortic valve implantation in a patient with severe left ventricular hypertrophy. The valve was deployed but failed to attain stable seating because of a hypertrophied septal ridge encroaching on the landing zone. Moderate perivalvar insufficiency was also noted. A second valve was deployed in an attempt to achieve stable seating and correct the perivalvar leak. This was unsuccessful and the two-valve complex embolized into the ascending aorta. The valves were moved and seated in the proximal descending thoracic aorta. The technical issues of transapical aortic valve implantation in patients with severe left ventricular hypertrophy are reviewed.
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