European heart journal. Case reports · 2025
First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic mitral valve after fracturing the discs: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Butter Christian, Neuss Michael, Kücken Tanja, Bensch Doreen, Erb Michael
Аннотация
BACKGROUND: Until now, dysfunctional mechanical valves had to be treated surgically. Motivated by in vitro fracture experiments and the first successful clinical implantation of a transcatheter valve (TAVR) into the remaining ring in aortic position, this approach was considered for the mitral position for the first time.
CASE SUMMARY: A 31-year-old female patient with a history of four open-heart surgeries and severe neurologic complications presented with cardiac decompensation due to a fixed tilt of her mechanical bileaflet mitral valve prosthesis, resulting in mitral stenosis with a mean gradient of above 10 mmHg. An interventional approach was discussed. Using an apical access, the tilts were cracked under cerebral protection, and a balloon-implantable TAVR was implanted uneventfully. More than 3 years later, the patient is clinically stable, the valvular function is not impaired and the embolized fragment does not cause any problems in the distal abdominal aorta.
DISCUSSION: To the best of our knowledge, this is the first case report that demonstrates the possibility to implant a biological TAVR in a failed bileaflet mechanical mitral valve after fracturing the carbon tilts.
CASE SUMMARY: A 31-year-old female patient with a history of four open-heart surgeries and severe neurologic complications presented with cardiac decompensation due to a fixed tilt of her mechanical bileaflet mitral valve prosthesis, resulting in mitral stenosis with a mean gradient of above 10 mmHg. An interventional approach was discussed. Using an apical access, the tilts were cracked under cerebral protection, and a balloon-implantable TAVR was implanted uneventfully. More than 3 years later, the patient is clinically stable, the valvular function is not impaired and the embolized fragment does not cause any problems in the distal abdominal aorta.
DISCUSSION: To the best of our knowledge, this is the first case report that demonstrates the possibility to implant a biological TAVR in a failed bileaflet mechanical mitral valve after fracturing the carbon tilts.