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Repeat transcatheter aortic valve replacement using a 23 mm Evolut R in a small patient with a failed 20 mm SAPIEN XT

  • Mike Saji
  • Tetsuya Tobaru
  • Ryosuke Higuchi
  • Shuichiro Takanashi
  • Morimasa Takayama
  • Mitsuaki Isobe
Images in Cardiovascular Intervention
  • 46 Downloads
An 85-year-old small woman (body surface area of 1.0 m 2) presented with acute heart failure requiring non-invasive positive pressure ventilation. Her past medical history included rheumatic arthritis with immunosuppression therapy. She previously had a successful transfemoral transcatheter aortic valve replacement (TAVR) with the 20 mm SAPIEN XT (Edwards Lifesciences) in 2011 without complication. Her symptom was improved. However, follow-up transthoracic echocardiography (TTE) demonstrated maximal aortic valve velocity of 2.9 m/s at discharge, although the leaflets were fully opened. In emergent admission 6 years after the first TAVR, TTE demonstrated maximal aortic valve velocity of 6.2 m/s with calcified leaflets of the 20 mm SAPIEN XT which resulted in decompensated heart failure (Fig.  1a), and salvage intervention was required. Transfemoral Valve-in-Valve TAVR using the 23 mm Evolut R (Medtronic) was urgently planned based on the computed tomography (Fig.  1b). Severely calcified...

References

  1. 1.
    Rodriguez-Gabella T, Voisine P, Puri R, et al. Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration. J Am Coll Cardiol. 2017;70(8):1013–28.CrossRefPubMedGoogle Scholar
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    Dvir D, Webb JG, Bleiziffer S, et al. Transcatheter aortic valve implantation in failed bioprosthetic surgical valves. JAMA. 2014;312(2):162–70.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2018

Authors and Affiliations

  1. 1.Department of CardiologySakakibara Heart InstituteTokyoJapan
  2. 2.Department of Cardiovascular SurgerySakakibara Heart InstituteTokyoJapan

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