High-risk Trans-Catheter Aortic Valve Replacement in a Failed Freestyle Valve with Low Coronary Height: A Case Report

Ashkan Karimi, Negiin Pourafshar, George Dibu, Thomas M. Beaver, Anthony A. Bavry

Research output: Contribution to journalArticlepeer-review

Abstract

A 55-year-old male with a history of two prior cardiac surgeries presented with decompensated heart failure due to severe bioprosthetic aortic valve insufficiency. A third operation was viewed prohibitively high risk and valve-in-valve trans-catheter aortic valve replacement was considered. There were however several high-risk features and technically challenging aspects including low coronary ostia height, poor visualization of the aortic sinuses, and difficulty in identification of the coplanar view due to severe aortic insufficiency, and a highly mobile aortic valve mass. After meticulous peri-procedural planning, trans-catheter aortic valve replacement was carried out with a SAPIEN 3 balloon-expandable valve without any complication. Strategies undertaken to navigate the technically challenging aspects of the case are discussed.

Original languageEnglish (US)
Pages (from-to)145-150
Number of pages6
JournalCardiology and Therapy
Volume6
Issue number1
DOIs
StatePublished - Jun 1 2017

Keywords

  • Bioprosthesis
  • Edwards SAPIEN 3 valve
  • Freestyle aortic root
  • Trans-catheter aortic valve replacement
  • Valve-in-valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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