scholarly journals Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report

2019 ◽  
Author(s):  
Ahmet Korkmaz ◽  
Havva Tuğba Gürsoy ◽  
Mehmet İleri ◽  
Özgül Uçar Elalmış ◽  
Ümit Güray
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Transcatheter Aortic Valve

Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or who are unsuitable candidates for open-heart surgery. However, concerns exist over treating patients who have undergone previous mitral valve surgery due to the potential interference between the mitral prosthetic valve or ring and the TAVI device. In this case report, we present a case in which a patient with symptomatic severe aortic stenosis and previous mechanical mitral valve replacement was successfully treated with TAVI using a Portico valve, which is under-researched.   J Teh Univ Heart Ctr 2019;14(2):85-89   This paper should be cited as: Korkmaz A, Gürsoy HT, İleri M, Uçar Elalmış Ö, Güray Ü. Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report. J Teh Univ Heart Ctr 2019;14(2):85-89.

scholarly journals Prosthetic Valve Endocarditis with Valvular Obstruction after Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 42 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Christine Pabilona ◽  
Bernard Gitler ◽  
Jeffrey A. Lederman ◽  
Donald Miller ◽  
Theodore N. Keltz
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Prosthetic Valve Endocarditis ◽  
Transcatheter Aortic Valve

Patients with severe aortic stenosis who are at high risk for open-heart surgery might be candidates for transcatheter aortic valve replacement (TAVR). To our knowledge, this is the first report of Streptococcus viridans endocarditis that caused prosthetic valve obstruction after TAVR. A 77-year-old man who had undergone TAVR 17 months earlier was admitted because of evidence of prosthetic valve endocarditis. A transthoracic echocardiogram revealed a substantial increase in the transvalvular peak gradient and mean gradient in comparison with an echocardiogram of 7 months earlier. A transesophageal echocardiogram showed a 1.5-cm vegetation obstructing the valve. Blood cultures yielded penicillin-sensitive S. viridans. The patient was hemodynamically stable and was initially treated with vancomycin because of his previous penicillin allergy. Subsequent therapy with levofloxacin, oral penicillin (after a negative penicillin skin test), and intravenous penicillin eliminated the symptoms of the infection. Transcatheter aortic valve replacement is a relatively new procedure, and sequelae are still being discovered. We recommend that physicians consider obstructive endocarditis as one of these.

Transcatheter Aortic Valve Implantation after Previous Mechanical Mitral Valve Replacement: Expanding Indications?

2011 ◽  
Vol 14 (3) ◽  
pp. 166 ◽  
Author(s):  
Carsten J. Beller ◽  
Raffi Bekeredjian ◽  
Ulrike Krumsdorf ◽  
R�diger Leipold ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Transcatheter Aortic Valve ◽  
Mitral Valve Prosthesis ◽  
Risk Patients

<p><b>Background:</b> Cardiac operation for severe aortic stenosis after previous mitral valve replacement is a surgical challenge in older patients with multiple morbidities. Transcatheter aortic valve implantation (TAVI) after previous mechanical mitral valve replacement has been considered a high-risk procedure, owing to possible interference with the mitral valve prosthesis.</p><p><b>Methods:</b> Since August 2008, 5 female high-risk patients with severe aortic stenosis and previous mitral valve replacement (mean � SD age, 80 � 5.1 years; logistic EuroSCORE, 39.3% � 20.5%) underwent TAVI with a pericardial xenograft valve that was fixed with a stainless steel, balloon-expandable stent (Edwards Lifesciences SAPIEN). We used a transapical approach in 4 patients and a transfemoral approach in 1 patient. Transesophageal echocardiography and multidetector computed tomography were used for preoperative planning and assessment of operation feasibility. The mean distance between the aortic annulus and the mitral valve prosthesis was 10 � 1 mm (range, 9-11 mm).</p><p><b>Results:</b> TAVI was performed successfully in all 5 patients. There was no direct or functional interference with the mechanical mitral valve prostheses. Echocardiography revealed good valve function with no more than mild paravalvular incompetence early in the postoperative period and during routine follow-up. There were no neurologic events. After an initially uneventful course with good aortic valve function at the most recent echocardiography evaluation, however, 2 of the patients died from fulminant pneumonia on postoperative days 4 and 48.</p><p><b>Conclusion:</b> TAVI is technically feasible in high-risk patients after previous mechanical mitral valve replacement; however, careful patient selection is mandatory with respect to preoperative clinical status and anatomic dimensions regarding the distance between aortic annulus and mitral valve prosthesis.</p>

scholarly journals Mitral valve replacement after transcatheter aortic valve implantation in a patient with rheumatic heart disease and prior Ross procedure: a case report

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Khaled D. Algarni ◽  
Amr A. Arafat
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Ross Procedure ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Reoperations are required frequently after the Ross procedure in rheumatic patients. The use of transcatheter aortic valve implantation (TAVI) in those patients could decrease the risk of future open procedure; however, the outcome may be affected by the concomitant mitral valve disease, and subsequent mitral reoperation may distort the implanted aortic valve. Case presentation We present a female patient who had a beating mitral valve replacement after valve-in-valve TAVI in a patient with prior Ross procedure. Weaning from cardiopulmonary bypass was difficult, and the patient needed extra-cardiac membrane oxygenation (ECMO) and intra-aortic balloon pump because of right ventricular dysfunction. The right ventricular dysfunction could be due to the concomitant coronary artery disease or air embolism during the beating mitral valve surgery. Recovery was gradual, and the patient was discharged after 33 days. Pre-discharge echocardiography showed a maximum gradient of 9 mmHg on the aortic valve and mild paravalvular leak. Conclusions Mitral valve replacement in a patient with prior TAVI and the Ross procedure was feasible; it decreased the operative risk and did not distort the implanted aortic valve.

Mitral valve perforation during transcatheter aortic valve replacement

2020 ◽  
Vol 28 (5) ◽  
pp. 276-278
Author(s):  
Shotaro Higa ◽  
Takaaki Nagano ◽  
Satoshi Yamashiro ◽  
Masashi Iwabuchi
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Direct Closure ◽  
Open Conversion ◽  
Transcatheter Aortic Valve ◽  
Stiff Guidewire

An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. After placement of the prosthetic valve, intraoperative transesophageal echocardiography revealed severe mitral regurgitation from the anterior mitral leaflet. Open conversion was performed immediately. A 5-mm hole was identified in the anterior leaflet, and direct closure was chosen for mitral valve repair. While transcatheter aortic valve replacement has gained popularity for patients with severe aortic stenosis and high operative risk, reports of mitral valve perforation are rare.

scholarly journals Transcatheter aortic valve replacement in patients with previous mitral valve replacement. A systematic study

2020 ◽  
Vol 16 (2) ◽  
pp. 177-183
Author(s):  
Zbigniew Chmielak ◽  
Maciej Dąbrowski ◽  
Paweł Tyczyński ◽  
Krzysztof Kukuła ◽  
Ilona Michałowska ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Systematic Study ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve

scholarly journals Early results of a real-world series with two transapical transcatheter mitral valve replacement devices

2020 ◽  
Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Functional Improvement ◽  
Study Cohort ◽  
Early Results ◽  
Transcatheter Mitral Valve Replacement

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract

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