Complex transcatheter aortic valve replacement in aortic regurgitation and transcatheter mitral annuloplasty in severe dextrocardia

Eur J Cardiothorac Surg. 2021 Oct 22;60(4):997-999. doi: 10.1093/ejcts/ezab124.

Abstract

A 70-year-old female with symptomatic severe native aortic regurgitation, acquired dextrocardia, moderate-to-severe secondary mitral regurgitation and prohibitive surgical risk was admitted for transcatheter aortic valve replacement. A balloon-expendable Sapien 3 Ultra valve was implanted successfully. After 6 months, the patient remained symptomatic due to the concomitant moderate-to-severe secondary mitral regurgitation. Transcatheter mitral valve repair using a Carillon Mitral Contour System was performed resulting in a significant reduction of mitral regurgitation and uneventful follow-up. Most importantly, other transcatheter repair techniques would not have been feasible due to the impossible transoesophageal echocardiography guidance. This is the first case of transcatheter aortic valve replacement in a patient with native aortic regurgitation, acquired dextrocardia and severe aortic annulus malrotation using a balloon-expendable valve. Moreover, it is the first transcatheter mitral valve repair procedure using Carillon device performed by a cardiac surgeon.

Keywords: Aortic regurgitation; Dextrocardia; Mitral valve regurgitation; Transcatheter aortic valve replacement; Transcatheter mitral valve repair.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Insufficiency* / diagnostic imaging
  • Aortic Valve Insufficiency* / surgery
  • Dextrocardia* / complications
  • Dextrocardia* / diagnostic imaging
  • Dextrocardia* / surgery
  • Female
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Annuloplasty*
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / surgery
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome