JACC. Case reports · 2026
Emergency Transcatheter Aortic Valve Replacement in Cardiogenic Shock Caused by Severe Bicuspid Aortic Valve Stenosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Jurisic Martin, Starnecker Fabian, Joner Michael, Rheude Tobias
Аннотация
BACKGROUND: Treatment of severe aortic stenosis in cardiogenic shock remains challenging, particularly in younger patients with bicuspid valve stenosis (BVS).
CASE SUMMARY: A 51-year-old woman with severe high-gradient BVS presented in cardiogenic shock with multiorgan dysfunction. Given hemodynamic instability, the heart team proceeded with urgent transcatheter aortic valve replacement. A 26-mm balloon-expandable Edwards SAPIEN 3 Ultra RESILIA valve was successfully implanted, resulting in rapid hemodynamic stabilization.
DISCUSSION: This case highlights the importance of urgent heart team decision-making in unstable patients with severe BVS. Lifetime management requires individualized device selection considering annular dimensions, calcification pattern, coronary access, and future redo-procedure strategies.
TAKE-HOME MESSAGES: In the presence of refractory cardiogenic shock, transcatheter aortic valve replacement may be the preferred treatment strategy and should be considered as part of an individualized lifetime management strategy.
CASE SUMMARY: A 51-year-old woman with severe high-gradient BVS presented in cardiogenic shock with multiorgan dysfunction. Given hemodynamic instability, the heart team proceeded with urgent transcatheter aortic valve replacement. A 26-mm balloon-expandable Edwards SAPIEN 3 Ultra RESILIA valve was successfully implanted, resulting in rapid hemodynamic stabilization.
DISCUSSION: This case highlights the importance of urgent heart team decision-making in unstable patients with severe BVS. Lifetime management requires individualized device selection considering annular dimensions, calcification pattern, coronary access, and future redo-procedure strategies.
TAKE-HOME MESSAGES: In the presence of refractory cardiogenic shock, transcatheter aortic valve replacement may be the preferred treatment strategy and should be considered as part of an individualized lifetime management strategy.