Application of transcatheter valves for aortic valve replacement in pediatric patients: A case series

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in drastic changes to the practice of medicine, requiring healthcare systems to find solutions to reduce the risk of infection. Using a case series, we propose a protocol for same-day discharge (SDD) for selected patients undergoing transcatheter aortic valve replacement (TAVR) using real-time remote cardiac monitoring. Six patients with severe symptomatic aortic stenosis underwent TAVR and were discharged on the same day. Case summary Six patients with symptomatic severe native or bioprosthetic aortic valve stenosis underwent a successful transfemoral TAVR using standard procedures, including the use of rapid atrial pacing to assess the need for permanent pacemaker implantation. Following TAVR, patients were monitored on telemetry in the recovery area for 3 h, ambulated to assess vascular access stability, and discharged with real-time remote cardiac monitoring if no new conduction abnormality was observed. The patients were seen by tele-visits within 2 days and 2 weeks after discharge. Discussion Amidst the COVID-19 pandemic, SDD following successful transfemoral TAVR may be feasible for selected patients and reduce potential COVID-19 exposure.

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Safety and feasibility of transcatheter aortic valve replacement in COVID-19 patients: A case series

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2021.03.022 ◽

2021 ◽

Author(s):

Enrico Giacomin ◽

Alberto Barioli ◽

Luca Favero ◽

Davide Lanzellotti ◽

Diego Calzolari ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Case Series ◽

Transcatheter Aortic Valve

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Appropriate patient selection or health care rationing? Lessons from surgical aortic valve replacement in the Placement of Aortic Transcatheter Valves I trial

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2015.05.073 ◽

2015 ◽

Vol 150 (3) ◽

pp. 557-568.e11 ◽

Cited By ~ 6

Author(s):

Wilson Y. Szeto ◽

Lars G. Svensson ◽

Jeevanantham Rajeswaran ◽

John Ehrlinger ◽

Rakesh M. Suri ◽

...

Keyword(s):

Health Care ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Patient Selection ◽

Health Care Rationing ◽

Surgical Aortic Valve Replacement ◽

Care Rationing ◽

Transcatheter Valves

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A tale of four valves: outcome of Brucella endocarditis: a case series

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz035 ◽

2019 ◽

Vol 3 (2) ◽

Author(s):

Suraj Kumar Kulkarni ◽

Shivakumar Bhairappa ◽

Kapil Rangan ◽

Beeresh P

Keyword(s):

New York ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Case Series ◽

Heart Association ◽

Limb Ischaemia ◽

Intermittent Fever ◽

Peripheral Embolization ◽

Acute Limb Ischaemia

Abstract Background Brucellosis is a zoonotic infection. Humans contract brucellosis through inhalation of aerosolized infected particles, or when they come in direct contact with infected animal parts, or on consuming unpasteurised dairy products. It can affect multiple organs and systems. Endocarditis is diagnosed late in the course of the disease with mostly aortic valve involvement with serious morbidity and mortality. Case summary We report a case series of four patients with Brucella endocarditis. The first patient presented with fever, malaise, and exertional breathlessness. He underwent aortic valve replacement for refractory heart failure and bulky vegetations after failed medical therapy. The second patient presented with fever, breathlessness New York Heart Association (NYHA) III, with arthralgia, myalgia, anorexia, and weight loss. In view of aortic abscess with impending rupture and compression of left main coronary artery, aortic valve replacement was performed on the 4th day of antibiotic treatment. The third patient presented with fever, fatigue, NYHA II, and developed peripheral embolization but responded to medical treatment alone. The fourth patient presented with intermittent fever for 7 months. During hospitalization, he suffered acute limb ischaemia and stroke with absence of left dorsalis pedis and posterior tibial pulsation. Brucella IgG ELISA was positive. Mitral valve replacement was done subsequently with unremarkable hospital course. Discussion Brucellosis is a challenging diagnosis to make. The diagnosis and treatment is often delayed as it presents with non-specific symptoms and signs. Cardiac involvement occurs in only 2% of the cases, but accounts for 80% of the mortality due to brucellosis. Brucella endocarditis should be suspected in cases of endocarditis with negative blood cultures and a risk of exposure. The most accepted treatment for Brucella endocarditis is a combination of antimicrobial therapy with surgery.

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