Transcatheter aortic valve implantation in a patient with unicuspid aortic valve

Angelo Nascimbene, Pranav Loyalka, Igor D. Gregoric, Ricardo Bellera, Maan Malahfji, Marija Petrovic, Biswajit Kar

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)127-130
Number of pages4
JournalTexas Heart Institute Journal
Volume44
Issue number2
DOIs
StatePublished - Apr 2017

Keywords

  • Aortic valve stenosis/therapy
  • Aortic valve/abnormalities/pathology
  • Cardiac catheterization/instrumentation
  • Congenital/complications
  • Heart defects
  • Heart valve diseases
  • Heart valve prosthesis implantation/methods

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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