European heart journal. Case reports · 2026
Bailout transcatheter mitral valve implantation for extensive valvular and atrial calcifications during triple-valve surgery in a patient with long-lasting renal replacement therapy: a case report.
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Verolino Giuseppe, van der Velden Kim E H M, Sauren Barthel W, Kats Suzanne, Lorusso Roberto
Аннотация
BACKGROUND: We present a successful case of triple-valve surgery, including bailout open-heart transcatheter mitral valve implantation, in a haemodialysis patient with extensive intracardiac calcifications.
CASE SUMMARY: A middle-aged woman with exercise-induced dyspnoea and an end-stage kidney disease on renal replacement therapy was admitted to the emergency department for severe hypotension and bradycardia. A high-degree AV block was diagnosed. Multimodal imaging exams also revealed a triple severe valvular disease (mitral stenosis, aortic stenosis, and tricuspid regurgitation) with an unclear cardiac mass enclosed within the left atrial wall. To avoid potentially dangerous decalcification for valve replacement, a combined traditional surgical approach and transcatheter valve implantation have been successfully applied.
DISCUSSION: The current case confirms that open-heart transcatheter valve implantation at the mitral position in the presence of marked calcifications involving the valve apparatus, atrial, and ventricular walls is a valuable option, potentially avoiding dangerous decalcification, achieving effective mitral valve stenosis relief, and shortening surgical times.
CASE SUMMARY: A middle-aged woman with exercise-induced dyspnoea and an end-stage kidney disease on renal replacement therapy was admitted to the emergency department for severe hypotension and bradycardia. A high-degree AV block was diagnosed. Multimodal imaging exams also revealed a triple severe valvular disease (mitral stenosis, aortic stenosis, and tricuspid regurgitation) with an unclear cardiac mass enclosed within the left atrial wall. To avoid potentially dangerous decalcification for valve replacement, a combined traditional surgical approach and transcatheter valve implantation have been successfully applied.
DISCUSSION: The current case confirms that open-heart transcatheter valve implantation at the mitral position in the presence of marked calcifications involving the valve apparatus, atrial, and ventricular walls is a valuable option, potentially avoiding dangerous decalcification, achieving effective mitral valve stenosis relief, and shortening surgical times.