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Simultaneous transcatheter transfemoral aortic and transeptal mitral valve replacement using Edward SAPIEN S3

Zaher Fanari1,2, Hadi Mahmaljy3, Shalish Nandish1

  • 1Division of Cardiology, Prairie Heart Institute, Springfield, Illinois.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 7, 2017
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) offer a feasible, minimally invasive treatment for elderly patients with severe aortic and mitral stenosis. This combined approach significantly improved symptoms in a high-risk patient.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Valvular Heart Disease

Background:

  • Elderly patients with severe aortic stenosis (AS) and severe mitral stenosis (MS) often have comorbidities, increasing surgical risk.
  • Severe mitral annular calcification (MAC) complicates treatment options for severe mitral stenosis.
  • Transcatheter mitral valve replacement (TMVR) presents an alternative for high-risk patients with severe MS and MAC.

Observation:

  • A case report details an 83-year-old male with symptomatic severe AS and severe native MS with severe MAC.
  • The patient had a high Society of Thoracic Surgeons (STS) score, indicating elevated surgical risk.
  • He also had moderate mitral regurgitation.

Findings:

  • A simultaneous transfemoral TAVR and transseptal TMVR procedure was successfully performed.
  • The combined transcatheter approach was feasible and minimally invasive.
  • The patient experienced significant symptom improvement post-procedure, sustained at 10-month follow-up.

Implications:

  • Simultaneous TAVR and transseptal TMVR is a viable treatment strategy for complex valvular heart disease.
  • This combined approach offers a less invasive option for high-risk elderly patients.
  • The findings suggest potential for improved outcomes and quality of life in this challenging patient population.

Keywords:
transcatheter aortic valve replacementtranscatheter mitral valve replacementtranseptal accesstransfemoral access

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