scholarly journals Bicuspid aortic valve with severe aortic stenosis: a case report

2016 ◽  
Vol 44 (2) ◽  
pp. 105-108
Author(s):  
Redoy Ranjan ◽  
Md Mushfiqur Rahman ◽  
Omar Sadeque Khan ◽  
Md Aftabuddin ◽  
Asit Baran Adhikary

A bicuspid aortic valve (BAV) can be a serious disorder of heart valve in which the valve only has two leaflets or flaps that control blood flow through the heart. Between one and two percent of all people have this defect and it affects more men than women. This report presents a case of severe aortic stenosis with mild to moderate aortic regurgitation due to bicuspid aortic valve with hypertension. A 37 years old male presented with high record of blood pressure and occasional shortness of breath on exertion. Echocardiography (Color Doppler) revealed severe aortic stenosis with mild to moderate aortic regurgitation due to bicuspid aortic valve with moderately severe concentric LV wall hypertrophy. Surgical treatment (aortic valve replacement) was scheduled based on echocardiography findings. On surgical resection a well defined bicuspid aortic valve was found with calcification and friable valve leaflet. Histopathology of valve tissue shows large areas of calcification. Patient was discharged from hospital on 7th POD with an advice to attend cardiac surgery OPD after 1 month. Aortic valve replacement must be considered in this type of lesion.Bangladesh Med J. 2015 May; 44 (2): 105-108

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Uoo Kim

Transcatheter aortic valve replacement (TAVR) has emerged as a feasible alternative for treatment of severe aortic stenosis with comparable outcomes to surgical aortic valve replacement (SAVR) in recent years. We present a case of device embolization in the left ventricular outflow tract (LVOT) during TAVR in a patient with severe aortic stenosis that required emergent surgical intervention. During the open-heart surgery for embolized prosthesis extraction and SAVR, both TEE exam and surgical specimen demonstrated bicuspid aortic valve and rheumatic nature of the valve with lack of calcification, which were identified to be the two main factors that contributed to the complication. In which the insufficient annular calcification increases the risk of device embolization due to lack of an adequate landing zone for device anchoring, and the anatomy of bicuspid valve contributes to the complication due to its associated large annular size and horizontal aorta. This case highlights device embolization as one possible complication of TAVR which is associated with substantial morbidity and mortality, the clinical management process was thoroughly documented with aortic angiography and transoesophageal echocardiography imaging.


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