Urgent reoperative transapical valve-in-valve shortly after a transapical aortic valve implantation.

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State: Public
Version: Final published version
Serval ID
serval:BIB_82425093AC97
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Urgent reoperative transapical valve-in-valve shortly after a transapical aortic valve implantation.
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Ferrari E., Locca D., Marcucci C., Jeanrenaud X.
ISSN
1873-734X (Electronic)
ISSN-L
1010-7940
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
46
Number
4
Pages
748-750
Language
english
Notes
Publication types: Journal Article
Abstract
Urgent reoperative transapical aortic valve-in-valve has never been proposed as a treatment option in case of a failed transcatheter aortic valve implantation (TAVI) or in case of worsening of an existing paravalvular leak, if this complication occurs right after, or a few days after, the primary transapical aortic valve implantation. Experienced surgeons should argue that after a transapical TAVI, the apex is damaged and fragile, with a high risk of irreparable ventricular tears and life-threatening bleeding if a second transapical procedure is scheduled during the acute phase. Nevertheless, if the patient is inoperable and the vascular status, including the ascending aorta, limits alternative accesses, the urgent reoperative transapical valve-in-valve becomes an alternative. We illustrate, for the first time ever, our experience with an 81-year old female patient who underwent a transapical (TA) TAVI with a Sapien? XT 23 mm. The day after the procedure, the patient haemodynamically worsened in combination with a worsening of a known (grade 1-2) paravalvular leak. Thus, on postoperative day two, an urgent transapical valve-in-valve was performed, and a second Sapien? XT 23 mm was placed, with an excellent haemodynamic result and absence of leak. The redo apical access did not appear very complicated and the postoperative recovery was uneventful.
Pubmed
Web of science
Open Access
Yes
Create date
02/09/2014 10:18
Last modification date
20/08/2019 15:42
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