Key result
Surgical bioprosthetic aortic valve replacement successfully treats severe trileaflet aortic stenosis with almost no calcification.
Why the study?
Severe aortic stenosis is most often caused by progressive valve calcification, but rare cases occur with little or no calcification.
Case Report (n=1)
Severe aortic stenosis can occur in elderly patients with trileaflet valves through fibrosis-predominant remodeling without significant calcification, indicating that CT-based calcium scoring may underestimate disease severity in this rare phenotype.
Severe aortic stenosis (AS) is most often caused by progressive valve calcification; however, rare cases occur with little or no calcification. We report a 79-year-old man with a trileaflet aortic valve and progressive, hemodynamically severe AS despite an almost complete absence of valve calcification (aortic valve calcium score of 76.5 Agatston units). Multimodality imaging confirmed the severity of obstruction, and the patient underwent successful surgical bioprosthetic aortic valve replacement with good postoperative outcomes. This case demonstrates that severe AS can occur in elderly patients with trileaflet valves through fibrosis-predominant remodeling without significant calcification, and that computed tomography-based calcium scoring may underestimate disease severity in this rare phenotype.
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Razaghi et al. (2026) conducted a case report in Severe aortic stenosis (n=1). Surgical bioprosthetic aortic valve replacement was evaluated on Postoperative outcomes. Surgical bioprosthetic aortic valve replacement successfully treated severe trileaflet aortic stenosis in a 79-year-old man with an almost complete absence of valve calcification (calcium score 76.5).
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