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TAVR Using a Premounted Dry Valve in a Patient With Severe Aortic Stenosis and Tortuous Descending Aorta
Siyang Fan1, Fei Yuan1, Xinmin Liu1
1Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Background:
Transcatheter aortic valve replacement (TAVR) with wet tissue valves have several limitations that compromise their durability and lifespan, and it is technically challenging in patients with a tortuous descending aorta.
Case Summary:
We report an 81-year-old woman with severe symptomatic aortic stenosis, characterized by a functionally bicuspid aortic valve with extensive calcification, horizontal heart configuration. and tortuous descending aorta. The patient underwent successful transfemoral TAVR using a premounted dry valve system with cerebral embolic protection and a minimalist approach.
Discussion:
This case confirms the feasibility of long sheath-assisted TAVR using a premounted dry valve system. Given the availability of premounted dry valves in China, the use of a premounted dry valve with potentially enhanced durability was chosen to avoid the risk of reintervention in this elderly patient.
Take-Home Message:
Successful TAVR using a premounted dry valve system in patients with complex anatomy requires meticulous preprocedural planning, advanced imaging analysis, and appropriate device selection.
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