Dacron Patch Closure of Ventricular Septal Defect with Concomitant Aortic Valve Replacement using a Mechanical Prosthesis: A Video Presentation

AbstractWe performed Dacron patch closure of ventricular septal defect with concomitant aortic valve replacement using a St. Jude Medical mechanical aortic prosthesis for a patient with ventricular septal defect and severely deformed and irreparable aortic valve. We highlight the technical details of the procedure to prevent paravalvular aortic leakage and residual ventricular septal defect.

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Technical Details of Redo Aortic Valve Replacement using St. Jude Medical Mechanical Prosthesis in a Patient with Thrombosed Aortic Mechanical Prosthesis: A Video Presentation

Clinical Cardiology and Cardiovascular Interventions ◽

10.31579/2641-0419/224 ◽

2021 ◽

Vol 4 (18) ◽

pp. 01-03

Author(s):

Ujjwal K. Chowdhury ◽

Niwin George ◽

Lakshmi Kumari Sankhyan ◽

Shikha Goja ◽

Sumanth Raghuprakash ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Prosthetic Valve ◽

Consensus Guidelines ◽

Mechanical Prosthesis ◽

Video Presentation ◽

Jude Medical ◽

Technical Details

Current consensus guidelines of the AHA and ESC, uniformly recommend either type of prosthetic valve for patients aged 60 to 70 years and mechanical prosthesis for patients aged less than 60 years

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More in, better out? Successful valve-in-valve procedure of an iatrogenic ventricular septal defect following transcatheter aortic valve replacement: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab097 ◽

2021 ◽

Vol 5 (5) ◽

Author(s):

Klaus-Dieter Hönemann ◽

Steffen Hofmann ◽

Frank Ritter ◽

Gerold Mönnig

Keyword(s):

Aortic Valve ◽

Ventricular Septal Defect ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Septal Defect ◽

Left Ventricular ◽

Heart Team ◽

Transcatheter Aortic Valve ◽

Valve In Valve

Abstract Background A rare, but serious, complication following transcatheter aortic valve replacement (TAVR) is the occurrence of an iatrogenic ventricular septal defect (VSD). Case summary We describe a case of an 80-year-old female who was referred with severe aortic stenosis for TAVR. Following thorough evaluation, the heart team consensus was to proceed with implantation via a transapical approach of an ACURATE neo M 25 mm valve (Boston Scientific, Natick, MA, USA). The valve was deployed harnessing transoesophageal echocardiographic (TOE) guidance under rapid pacing with post-dilation. Directly afterwards a very high VSD close to the aortic annulus was detected. As the patient was haemodynamically stable, the procedure was ended. The next day another TOE revealed a shunt volume (left-to-right ventricle) between 50% and 60%. Because the defect was partly located between the stent struts of the ACURATE valve decision was made to fix this leakage with implantation of a further valve and we chose an EVOLUT Pro 29 mm (Medtronic Inc., Minneapolis, MN, USA). The valve-in-valve was implanted 2–3 mm below the lower edge of the first valve, more towards the left ventricular outflow tract (LVOT) with excellent result: VSD was reduced to a very small residual shunt without any hemodynamic relevance. Discussion We suggest that an iatrogenic VSD located near the annulus may be treated percutaneously in a bail-out situation with implantation of a second valve that should be implanted slightly more into the LVOT to cover the VSD.

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