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Transcatheter Aortic Valve Replacement and Percutaneous Coronary Intervention After Ozaki Procedure in Alagille
Benedikt Mayr1, Nazan Puluca1, Johannes Böhm1
1Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Background:
The Ozaki procedure is a novel therapeutic alternative to aortic valve replacement that involves excision of the native valve and replacement with neo-leaflets trimmed from the patient's pericardium.
Case Summary:
A 35-year-old man with Alagille syndrome and severe symptomatic stenosis of his neo-aortic valve was admitted 4 years after an Ozaki procedure. Given his high risk of redo surgery and nonsusceptibility to oral anticoagulation, valve-in-valve transcatheter aortic valve replacement (TAVR) with RESILIA tissue was performed. Despite preoperative imaging and good feasibility of TAVR after Ozaki, temporary obstruction of the right coronary artery occurred after TAVR, which was successfully resolved by ostial stent implantation.
Discussion:
Published reports on TAVR after Ozaki are sparse, especially in patients with rare multisystem disorders such as Alagille syndrome.
Take-Home Message:
TAVR after Ozaki in patients with Alagille syndrome can be successfully performed by a multidisciplinary heart team with special care regarding potential coronary occlusion.
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