Valve-in-Valve Transcatheter Aortic Valve Replacement in a High-Risk Patient with a Biocor Bioprosthesis and a Flail Prosthetic Valve Leaflet  

作　　者：Oliver Abela Michael Schoeller Parker Williams Charles Lambert Marc Bloom 

机构地区：[1]AdventHealth Tampa Pepin Heart Institute,Cardiology,3100 East Fletcher Avenue,Tampa,FL 33613,USA [2]DeBusk College of Osteopathic Medicine,Lincoln Memorial University,Cardiology,6965 Cumberland Gap Parkway,Harrogate,TN 37752,USA [3]AdventHealth Tampa Pepin Heart Institute,Cardiothoracic Surgery,3100 East Fletcher Avenue,Tampa,FL 33613,USA

出　　处：《Cardiovascular Innovations and Applications》2022年第1期191-194,共4页心血管创新与应用（英文）

摘　　要：An 80-year-old woman with a history of surgical aortic valve replacement with a 21 mm St.Jude Medical Biocor porcine aortic valve 14 years prior presented with New York Heart Association(NYHA)class III symptoms,severe aortic insufficiency from a degenerated prosthesis,and a large echocardiographic mobile mass representing a highly mobile prosthetic leaflet.The patient worsened to NYHA class IV symptoms despite medical management.The So-ciety of Thoracic Surgery mortality risk score was extremely high.However,a valve-in-valve transcatheter aortic valve replacement(TAVR)was found to be a reasonable option.We used a 20 mm SAPIEN 3 Ultra valve(Edwards Lifesciences Inc.,Irvine,CA,USA)with a SENTINEL embolic protection device(Boston Scientific,Marlborough,MA,USA).During valve deployment,the echocardiographic mobile mass was visually pinned between the new TAVR valve and the surgical bioprosthetic valve.No large embolic debris was noted within the embolic protection device,and the patient remained without any new focal neurologic deficits in the perioperative period and at the 30-day follow-up.The severe aortic insufficiency resolved,and the patient clinically improved to NYHA class II symptoms.

关 键 词：Bioprosthetic TAVR REGURGITATION 

分 类 号：R65[医药卫生—外科学]