Prosthetic Aortic Valve Migration Into the Left Ventricular Outflow Tract in Takayasu Arteritis.

BACKGROUND

Prosthetic valve-related complications are well recognized in Takayasu arteritis (TAK). However, migration of a prosthetic aortic valve into the left ventricular outflow tract (LVOT) is exceedingly rare.

CASE SUMMARY: We report 2 patients with TAK who experienced downward migration of the aortic prosthetic valve into the LVOT after aortic valve replacement, without any evident paravalvular leak. In patient 2, progressive valve migration led to mechanical interference with the anterior mitral leaflet, resulting in hemodynamics similar to those of mitral stenosis. In both cases, valve migration advanced over time and ultimately necessitated double valve replacement. The underlying mechanism for this phenomenon could not be determined, and histopathological confirmation was not feasible because of insufficient tissue sampling.

CONCLUSIONS

Prosthetic valve migration into the LVOT represents a rare but clinically significant form of valve dysfunction in TAK, which may progress without overt regurgitation and necessitate complex reoperative valve surgery.