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Transcatheter Aortic Valve Replacement for Valvular Shock in an Extremely Large Annulus
Rahul Annabathula1, Anweshan Samanta1, Haytham Allaham1
1Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Background:
Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for severe aortic stenosis in many clinical scenarios, offering several benefits over surgery. However, TAVR has limitations, especially in patients with complex aortic anatomy. TAVR in extremely large annuli (ELA) (>1,000 mm2) is technically challenging with limited data regarding its feasibility.
Case Summary:
A 65-year-old man presented in cardiogenic shock from combined severe aortic stenosis and regurgitation in an ELA. His surgical risk was prohibitive, and he underwent successful TAVR with resolution of his cardiogenic shock.
Discussion:
This is the first reported case of TAVR in an ELA for cardiogenic shock from combined severe aortic stenosis and regurgitation using a balloon-expandable valve.
Take-Home Messages:
This report highlights the feasibility of TAVR for severe aortic stenosis and aortic regurgitation in ELA complicated by cardiogenic shock. Further research is needed comparing surgical replacement and TAVR for patients with ELA.
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