Simultaneous double valve-in-valve TAVI procedure for failed bioprostheses

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Severe heart valve disease can significantly impair quality of life.
• Previous valve replacement surgery may necessitate reintervention.
• Transcatheter aortic valve implantation (TAVI) is an evolving treatment option for complex valve disease.

Observation:

• A 78-year-old female patient with a history of double valve replacement presented with New York Heart Association grade IV dyspnea.
• The patient's severe symptoms indicated a need for urgent intervention.
• Simultaneous valve-in-valve procedures were considered due to the patient's complex cardiac history.

Findings:

• A transapical valve-in-valve TAVI procedure was successfully performed in both the mitral and aortic positions.
• The patient experienced an uneventful postoperative course.
• Early extubation was achieved 6 hours post-procedure, indicating successful hemodynamic stability.

Implications:

• Simultaneous transapical valve-in-valve TAVI is a feasible option for patients with severe, symptomatic degenerated bioprosthetic valves in multiple positions.
• This approach may offer a less invasive alternative to repeat open-heart surgery.
• Successful TAVI can rapidly improve functional status and reduce hospital stay in high-risk patients.