Intraoperative Indocyanine Green Near-Infrared Angiography for Redo Valve Replacement
Brian Solomon1, Andreas Sarantopoulos1, Thomas Caranasos1
1Department of Cardiothoracic Surgery, Naples Community Hospital Healthcare System, Naples, Florida, United States.
Background:
Redo aortic interventions after failed transcatheter aortic valve replacement (TAVR) are challenging, particularly with low coronary heights and dense frame ingrowth.
Case Description:
An 83-year-old woman with prior TAVR developed severe prosthetic stenosis. Surgical Resection of Prosthetic Valve Leaflets Under Direct Vision (SURPLUS) with implantation of a balloon-expandable aortic valve and intraoperative low-dose indocyanine green (ICG) near-infrared (NIR) angiography was performed. Real-time NIR imaging confirmed symmetric coronary opacification. The valve was well seated with improved ejection fraction (60-65%), and recovery was uneventful.
Conclusion:
SURPLUS with ICG-NIR angiography ensured coronary patency and safe hemodynamic restoration.
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