Key result
Combined transaortic TAVR and mitral repair maintains favorable hemodynamics with ~8 mm Hg aortic gradient at 18 months.
Why the study?
Vascular and valvular calcifications, commonly seen in renal patients, increase operative mortality and can preclude conventional valvular management.
Case Report (n=1)
This case demonstrates the feasibility and successful 18-month durability of a novel hybrid transaortic TAVR and mitral repair approach under deep hypothermic circulatory arrest in a technically inoperable patient.
Supports feasibility of hybrid transaortic TAVR and mitral repair in porcelain aorta; leaves open need for prospective validation before wider use.
Vascular and valvular calcifications, commonly seen in renal patients, increase operative mortality and can preclude conventional valvular management. We show a novel approach to treat aortic stenosis and degenerative mitral regurgitation under hypothermic circulatory arrest in a hemodialysis patient with aortic, mitral disease and porcelain aorta with surgical and transcatheter contraindications.
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Pitoulis et al. (2023) conducted a case report in Severe aortic stenosis, severe mitral regurgitation, and porcelain aorta (n=1). Transaortic TAVR and Mitral Valve Repair under Deep Hypothermic Circulatory Arrest was evaluated on Valve function and clinical recovery at 18 months. Transaortic TAVR and mitral repair successfully restored valve function, yielding a mean mitral gradient of 3 mm Hg and a mean aortic gradient of 8 mm Hg without regurgitation at 18 months.
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