Valve-in-valve redo TAVI successfully resolved persistent symptoms and eliminated significant leakage in a 70-year-old man with complex post-TAVI complications.
Case Report (n=1)
Redo TAVI is a viable strategy for managing complex post-TAVI complications including paravalvular leak and hypoattenuated leaflet thickening with transvalvular regurgitation.
Transcatheter aortic valve implantation (TAVI) is a cornerstone treatment for severe aortic stenosis; however, complications such as paravalvular leak (PVL), hypoattenuated leaflet thickening (HALT), and hypoattenuation affecting motion (HAM) can lead to persistent symptoms requiring reintervention. We report the case of a 70-year-old man with symptomatic severe aortic stenosis who underwent TAVI with a 27.5-mm Myval™ transcatheter heart valve (Meril Life Sciences, Vapi, Gujarat, India). Post-procedure, moderate PVL was identified, followed by persistent dyspnea at three months. Multimodal imaging, including transthoracic echocardiography, transesophageal echocardiography, and computed tomography, revealed HALT, HAM, and moderate-to-severe transvalvular leakage (TVL). Despite balloon post-dilation and anticoagulation therapy, symptoms persisted, necessitating a valve-in-valve redo TAVI with a 26-mm Myval™ transcatheter heart valve (Meril Life Sciences, Vapi, Gujarat, India). Follow-up imaging confirmed the absence of significant PVL or TVL, with complete resolution of symptoms. This case underscores the importance of multimodal imaging and individualized management strategies, including redo TAVI, in the treatment of complex post-TAVI complications.
Khalilipur et al. (Fri,) conducted a case report in Severe aortic stenosis with post-TAVI complications (n=1). Valve-in-valve redo TAVI was evaluated on Resolution of symptoms and absence of significant paravalvular or transvalvular leakage. Valve-in-valve redo TAVI successfully resolved persistent symptoms and eliminated significant leakage in a 70-year-old man with complex post-TAVI complications.