Concomitant Transcatheter Aortic and Mitral Valve Replacement.

BACKGROUND

Multivalvular heart disease is a highly prevalent condition that causes significant morbidity and mortality.

CASE SUMMARY: A 75-year-old man presented with worsening functional class and asthenia. A transthoracic echocardiogram showed severe aortic stenosis and severe mitral stenosis. The patient underwent transcatheter aortic and mitral valve replacement in the same procedure.

DISCUSSION: There is a lack of solid evidence regarding the management of multivalvular disease. Severe mitral stenosis can influence aortic stenosis, potentially leading to a low-flow, low-gradient profile. Establishing a streamlined workflow between transesophageal echo and cardiac tomography optimizes procedural safety, efficiency, and outcomes in patients with concomitant mitral and aortic disease.

TAKE-HOME MESSAGES: This case highlights the relevance of multimodality imaging for procedural planning in complex multivalvular disease. Concomitant transcatheter implantation of transcatheter aortic valve replacement for aortic stenosis followed by a transcatheter mitral valve replacement in mitral stenosis is a feasible option for patients at high surgical risk.