scholarly journals Self-Expandable Transcatheter Aortic Valve Frame Infolding: An Increasingly Recognized Complication

2020 ◽  
Author(s):  
Gurpreet Singh ◽  
Vien Le ◽  
Robert Wiechmann ◽  
Steven Schreiter
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Surgical Risk ◽  
Optimal Geometry ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve

Transcatheter aortic valve replacement (TAVR) with either a balloon-expandable or a self-expandable transcatheter heart valve (THV) is an approved therapy for patients with symptomatic severe aortic stenosis and high or intermediate surgical risk. Here we present a case of severe valve frame infolding of a CoreValve Evolut PRO® self-expandable THV (Medtronic Inc.), which was restored to optimal geometry with balloon post-dilation.

scholarly journals Transcatheter Aortic Valve Replacement in Young Low-Risk Patients With Severe Aortic Stenosis: A Review

2020 ◽  
Vol 7 ◽  
Author(s):  
Pier Paolo Bocchino ◽  
Filippo Angelini ◽  
Brunilda Alushi ◽  
Federico Conrotto ◽  
Giacomo Maria Cioffi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Low Risk ◽  
Surgical Risk ◽  
Transcatheter Aortic Valve ◽  
Risk Patients

In the last decades, transcatheter aortic valve replacement (TAVR) revolutionized the treatment of symptomatic severe aortic stenosis. The efficacy and safety of TAVR were first proven in inoperable and high-risk patients. Then, subsequent randomized clinical trials showed non-inferiority of TAVR as compared to surgical aortic valve replacement also in intermediate- and low-risk populations. As TAVR was progressively studied and clinically used in lower-risk patients, issues were raised questioning its opportunity in a younger population with a longer life-expectancy. As long-term follow-up data mainly derive from old studies with early generation devices on high or intermediate surgical risk patients, results can hardly be extended to most of currently treated patients who often show a low surgical risk and are treated with newer generation prostheses. Thus, in this low-risk younger population, decision making is difficult due to the lack of supporting data. The aim of the present review is to revise current literature regarding TAVR in younger patients.

scholarly journals Transcatheter Aortic Valve Implantation in a Patient with Unicuspid Aortic Valve

2017 ◽  
Vol 44 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Angelo Nascimbene ◽  
Pranav Loyalka ◽  
Igor D. Gregoric ◽  
Ricardo Bellera ◽  
Maan Malahfji ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Percutaneous Treatment ◽  
Aortic Insufficiency ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve

Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient. A 31-year-old woman with Turner syndrome—who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks—presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use. Postdeployment angiography and transesophageal echocardiography and aortography revealed no aortic insufficiency. Transcatheter aortic valve replacement for unicuspid aortic valve stenosis is technically feasible. Before implantation, particular attention should be paid to the interplay between the large single leaflet, coronary ostia, and stented valve, to select the correct size and position of the device. Some degree of intraoperative aortic migration should be anticipated.

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