Managing Severe Bicuspid Aortic Stenosis, Aortic Coarctation, and Impaired Left Ventricular Function
Oscar A Perez Orpinel1, Félix Damas de Los Santos2, Jessy Steve Masso-Bueso1
1Interventional Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
JACC. Case Reports
|September 19, 2025
Summary
A rare case of severe bicuspid aortic stenosis and coarctation in an elderly patient was successfully treated with a stepwise percutaneous approach. This strategy improved cardiac function and reduced procedural risks for transcatheter aortic valve replacement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Structural Heart Disease
Background:
- Bicuspid aortic valve and coarctation of the aorta often coexist.
- Diagnosis of these conditions in the elderly is uncommon.
- This case presents a unique diagnostic and therapeutic challenge in an octogenarian patient.
Related Concept Videos
Aortic Regurgitation III: Medical Management
399
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...
399
Mitral Stenosis III: Medical Management
247
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
247
Cardiomyopathy V: Interprofessional Care
339
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
339
Mitral Stenosis IV: Nursing Management
247
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
247
Cardiomyopathy III: Hypertrophic Cardiomyopathy
414
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
414
Mitral Regurgitation III: Medical Management
284
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
284


