Related Experiment Video
Updated: Jul 6, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
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.
JACC. Case Reports
|March 28, 2025
Summary
Transcatheter aortic valve replacement (TAVR) is feasible for patients with extremely large aortic annuli (ELA) experiencing cardiogenic shock. This case demonstrates successful TAVR for severe aortic stenosis and regurgitation in an ELA, offering a viable option when surgery is high-risk.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter aortic valve replacement (TAVR) is a preferred treatment for severe aortic stenosis.
- TAVR faces challenges in patients with complex aortic anatomy, particularly extremely large annuli (ELA) (>1,000 mm²).
- Limited data exists on TAVR feasibility in ELA.
Observation:
- A 65-year-old male patient presented with cardiogenic shock due to combined severe aortic stenosis and regurgitation.
- The patient had an extremely large aortic annulus (ELA).
- Surgical risk was prohibitive for the patient.
Findings:
- The patient underwent successful transcatheter aortic valve replacement (TAVR) using a balloon-expandable valve.
- Successful TAVR led to the resolution of cardiogenic shock.
- This represents the first reported case of TAVR in an ELA for cardiogenic shock from combined severe aortic stenosis and regurgitation.
Implications:
- TAVR is a feasible treatment option for severe aortic stenosis and regurgitation in ELA, even in patients with cardiogenic shock.
- This case highlights the potential of TAVR in complex aortic anatomies.
- Further comparative research is needed for TAVR versus surgical replacement in ELA patients.
More Related Videos
Related Concept Videos
01:24Blood Pressure Imbalances and Circulatory Shock
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:17Aortic Regurgitation IV: Nursing Management
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...