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Conventional surgery with partial septal myectomy and sutureless aortic valve replacement is a viable and potentially more appropriate option for patients with severe left ventricular hypertrophy and LVOT obstruction following TAVI.
Background Transarterial valve intervention (TAVI) is valuable in high-risk patients, however, in case of left ventricular outflow tract (LVOT) obstruction, conventional surgery, including partial myectomy, is indicated. Case Description An 84-year-old female patient presented with increasing fatigue after TAVI in 2012, demonstrated a narrowed LVOT. Conventional surgery was performed, including removal of the transcathether valve, partial septal myectomy, and implantation of a sutureless valve. The postoperative course was uncomplicated. Conclusion Aortic valve stenosis combined with severe left-ventricular hypertrophy is not ideal for TAVI. Conventional surgery, performing partial septal myectomy and implantation of sutureless aortic prosthesis, seems more appropriate.
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Dohmen et al. (2015) studied this question.
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