Transcatheter aortic valve implantation in a patient with mechanical mitral prosthesis: a lesson learned from an intraventricular clash

Catheter Cardiovasc Interv. 2013 Oct 1;82(4):E621-5. doi: 10.1002/ccd.24948. Epub 2013 May 28.

Abstract

We hereby present the case of a patient with severe aortic stenosis who underwent in her previous medical history a mitral valve replacement with a mechanical valve (Omnicarbon 27), and progressively developed a severe aortic stenosis. This patient was judged inoperable and then scheduled for CoreValve Revalving System implantation. Despite a good positioning of the CoreValve, an acute, severe mitral regurgitation developed soon after implantation as a consequence of the impaired movement of the mitral prosthesis leaflet. A condition of cardiogenic shock quickly developed. A good mitral prosthesis function was restored disengaging the CoreValve from the aortic annulus. After few months, the patients underwent successful Edwards-Sapien valve implantation through the Corevalve. This case strongly demonstrates how much a careful evaluation of the features of the mitral prosthesis and patient anatomy is crucial to select which specific transcatheter bioprosthesis would better perform.

Keywords: complications adult cath/intervention; congestive heart failure; valvular heart disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Bioprosthesis*
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Echocardiography, Transesophageal
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis*
  • Humans
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / etiology*
  • Mitral Valve Insufficiency / therapy
  • Patient Selection
  • Prosthesis Design
  • Prosthesis Failure*
  • Radiography, Interventional
  • Risk Factors
  • Severity of Illness Index
  • Shock, Cardiogenic / etiology
  • Tomography, X-Ray Computed
  • Treatment Outcome