Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Oct 2013
Case ReportsTranscatheter aortic valve implantation in a patient with mechanical mitral prosthesis: a lesson learned from an intraventricular clash.
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 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.
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Catheter Cardiovasc Interv · Oct 2013
Case ReportsTransseptal approach for the management of paravalvular regurgitation after transcatheter aortic valve replacement.
In the era of transcatheter aortic valve therapies, the presence of residual paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR) may become a clinical challenge. Management of late symptomatic PVR is still unknown. We describe a challenging case of percutaneous closure attempt of a clinically significant PVR in a patient after Edwards SAPIEN (Edwards Lifesciences, CA) TAVR.
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Catheter Cardiovasc Interv · Oct 2013
Multicenter StudyIncidence and predictors of permanent pacemaker implantation following transcatheter aortic valve implantation: analysis from the German transcatheter aortic valve interventions registry.
To determine predictors of permanent pacemaker (PPM) implantation up to 30 days after transcatheter aortic valve implantation (TAVI) in a prospective multicenter registry. ⋯ PPM is a common postprocedure requirement after TAVI. The absence of prior valve surgery, the implantation of Medtronic CoreValve™ prosthesis, and the presence of a porcelain aorta were independently associated with PPM after TAVI.
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Catheter Cardiovasc Interv · Oct 2013
Case ReportsAngioplasty of acquired pulmonary vein stenosis using covered stent.
One of the most serious complications post-catheter ablation of atrial fibrillation is the development of pulmonary vein stenosis. Controversy currently exists about the optimal treatment approach. The use of balloons and larger stents (~10 mm) results in more optimal outcome than just balloon angioplasty alone; however, even with stent implantation, recurrent restenosis may occur in 30 to 50% of patients. ⋯ This was initially stented with good result but soon after developed restenosis and required balloon angioplasty. Following the third episode of restenosis, stenting of the pulmonary vein was performed using a covered stent. The pulmonary vein has remained patent for the last 5 years.