Transcatheter Aortic Valve Implantation for Severe Bicuspid Aortic Stenosis With Concomitant Giant Cell Arteritis...

The use of transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic stenosis (AS) and aortitis has not been previously reported. Bicuspid AS creates significant challenges for TAVI due to complex anatomy. Furthermore, aortitis would make the case more challenging.

We report a case of a 71-year-old woman with a history of giant cell arteritis aortitis and severe bicuspid AS with low-flow, low-gradient who successfully underwent TAVI. The patient presented with acute heart failure with reduced ejection fraction. Following a thorough evaluation, a multidisciplinary team chose TAVI owing to the patient's high surgical risk and multiple comorbidities. Aortitis was managed with high-dose oral steroids for 2 weeks and subcutaneous tocilizumab. TAVI was performed successfully with a favorable short-term outcome.

This case demonstrates the feasibility of TAVI in severe bicuspid AS in patients with aortitis and emphasizes the need for careful patient selection.