Simultaneous transcatheter aortic and mitral valve-in-valve replacement: A case report

Rationale: There are fewer reports in China about re-performing combined transcatheter transcatheter aortic and mitral valve-in-valve replacement after bioprosthetic valve failure. Due to the higher difficulty of the combined secondary bivalve procedure and the greater risk of pericardial tamponade and malignant arrhythmias, the professional demands on the surgeon and team are extremely high. It is particularly important to provide quality perioperative care for such patients. Patient concerns: This study reports a case of bioprosthetic valve failure after undergoing transcatheter aortic and mitral bicuspid valve-in-valve replacement.After active treatment and careful care, the patient recovered well after the operation and had a good quality of life during the 1 year follow-up period. Diagnoses: Valve function was measured by 3-dimensional echocardiography. Interventions: The key points of perioperative care include: close monitoring of the patient’s condition and provision of first aid before surgery; close monitoring of hemodynamic parameters, management of fluid balance, provision of respiratory support and oxygen therapy management, prevention of complications and early cardiac rehabilitation after surgery. Outcomes: On the 16th day after the operation, the 3-dimensional echocardiogram showed that the mitral regurgitation was slight. Mitral regurgitation was slight, and aortic valve flow velocity and differential pressure were normalized. At 1 year follow-up, there were no adverse cardiovascular events and quality of life improved. Lessons: For patients undergoing simultaneous transcatheter bivalve replacement with multiple comorbidities, focus should be placed on constructing an integrated perioperative intervention pathway to comprehensively improve clinical tolerance and control the risk of complex cases.