First-in-man experience of percutaneous aortic valve replacement using self-expanding corevalve prosthesis

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomedical Engineering

Background:

• Severe aortic stenosis necessitates valve replacement.
• Transcatheter aortic valve implantation (TAVI) offers a less invasive alternative.
• The self-expanding CoreValve prosthesis represents a novel TAVI device.

Observation:

• The first-in-man implantation of the CoreValve prosthesis was performed on a 62-year-old patient with severe aortic stenosis, moderate aortic regurgitation, and significant comorbidities.
• The patient had renal failure and end-stage lung carcinoma.
• The procedure utilized general anesthesia and extracorporeal support via a retrograde approach.

Findings:

• Successful implantation of the CoreValve prosthesis resulted in a significant reduction of aortic valve gradients from 90 mm Hg to 16 mm Hg.
• The patient experienced a fatal outcome within four days post-procedure due to renal failure and bleeding diathesis, leading to multiorgan failure.

Implications:

• Percutaneous aortic valve replacement with the self-expanding CoreValve prosthesis is feasible in patients with severe aortic stenosis.
• Further long-term studies are required to establish the safety and efficacy of this approach.
• This case highlights the potential benefits and challenges of TAVI in complex patient populations.