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Valve-in-Valve in a Flail Bioprosthetic Mitral Valve With Endocarditis Using a Novel Embolic Protection Device
Yee Sen Chan Wah Hak1, Andrew G Chatfield1, Shaw Hua Kueh1
1Department of Cardiology, Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
JACC. Case Reports
|July 28, 2021
Summary
Transfemoral valve-in-valve transcatheter mitral valve replacement successfully treated a patient with Staphylococcus aureus endocarditis and a failing bioprosthetic mitral valve. A novel embolic protection device prevented neurologic complications during the advanced procedure.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Infective Endocarditis Management
Background:
- A 79-year-old woman presented with cardiogenic shock due to a flail bioprosthetic mitral valve leaflet.
- The patient also had Staphylococcus aureus endocarditis, complicating treatment options.
Observation:
- Standard treatment options were not viable for this complex case.
- Transfemoral valve-in-valve transcatheter mitral valve replacement was considered as a last resort.
Findings:
- A novel embolic protection device was utilized during the transcatheter mitral valve replacement.
- The procedure resulted in only trace mitral regurgitation.
- No neurologic complications were observed post-procedure.
Implications:
- This case demonstrates the feasibility of using valve-in-valve transcatheter mitral valve replacement with embolic protection in high-risk patients.
- It offers a potential solution for complex infective endocarditis involving prosthetic valves.
- Further research may explore the broader application of this technique and embolic protection devices.
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