Journal of cardiovascular medicine (Hagerstown, Md.) · 2019
Transfemoral transcatheter aortic valve replacement in the presence of a mitral prosthesis.
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Toutouzas Konstantinos, Drakopoulou Maria, Latsios George, Synetos Andreas, Stathogiannis Konstantinos, Soulaidopoulos Stergios, Oikonomou George, Trantalis George, Papanikolaou Aggelos, Aggeli Constantina, Vavuranakis Manolis, Mastrokostopoulos Antonis, Katsimaglis George, Voudris Vassilis, Dardas Petros, Tousoulis Dimitris
Аннотация
PURPOSE: In the current case series, we present our experience with the self-expanding CoreValve or Evolut R (Medtronic Inc.) in patients with severe symptomatic aortic valve stenosis and concomitant mitral valve prosthesis.
METHODS: Twelve patients with previous mitral valve prosthesis underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and/or aortic valve regurgitation. All patients underwent evaluation with an echocardiogram, computed tomography and coronary angiogram. After the index intervention and before discharge all patients underwent transthoracic echocardiography. All outcomes were defined according to the Valve Academic Research Consortium-2 criteria.
RESULTS: Eleven patients underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and one patient for severe aortic valve regurgitation. There was immediate improvement of patients' hemodynamic status; no cases of procedural death, stroke, myocardial infarction, or urgent cardiac surgery occurred. There was no 30-day mortality and all patients improved, with 91.6% in functional New York Heart Association class I-II.
CONCLUSION: The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results.
METHODS: Twelve patients with previous mitral valve prosthesis underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and/or aortic valve regurgitation. All patients underwent evaluation with an echocardiogram, computed tomography and coronary angiogram. After the index intervention and before discharge all patients underwent transthoracic echocardiography. All outcomes were defined according to the Valve Academic Research Consortium-2 criteria.
RESULTS: Eleven patients underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and one patient for severe aortic valve regurgitation. There was immediate improvement of patients' hemodynamic status; no cases of procedural death, stroke, myocardial infarction, or urgent cardiac surgery occurred. There was no 30-day mortality and all patients improved, with 91.6% in functional New York Heart Association class I-II.
CONCLUSION: The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results.
Предметные рубрики MeSH
AgedAged, 80 and overAortic ValveAortic Valve InsufficiencyAortic Valve StenosisCatheterization, PeripheralFemaleFemoral ArteryHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHemodynamicsHumansMaleMiddle AgedMitral ValveProsthesis DesignPuncturesRecovery of FunctionSeverity of Illness IndexTranscatheter Aortic Valve ReplacementTreatment Outcome