Key result
Open transcatheter aortic valve replacement (TAVI-in-homograft) on cardiopulmonary bypass was safely performed in a patient with a heavily calcified homograft, with the patient remaining asymptomatic at 14 months.
Why the study?
Redo surgery in patients who underwent aortic valve replacement with an aortic homograft can be technically challenging due to massive conduit calcification.
Case Report (n=1)
No
Open trans-aortic implantation of a transcatheter valve on cardiopulmonary bypass is a feasible and safe alternative to standard redo surgery for patients with severely calcified degenerated aortic homografts.
Supports feasibility in select calcified homograft cases; leaves open need for larger prospective studies.
BACKGROUND: Redo surgery in patient who underwent aortic valve replacement with an aortic homograft can result technically challenging because of the massive calcification of the conduit. CASE PRESENTATION: We present a case of a patient who underwent open surgery on cardiopulmonary bypass assistance to implant a standard transcatheter aortic bioprosthesis through aortotomy in an off-label procedure and we discuss its safety and feasibility. CONCLUSIONS: The combination of open cardiac surgery and open trans-aortic implant of a transcatheter prosthesis may reduce the surgical risk shrinking the technical difficulties that the implantation of a standard surgical prosthesis would have given.
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Gennari et al. (2019) conducted a case report in Degenerated calcified aortic homograft (n=1). Open transcatheter aortic valve replacement (TAVI-in-Homograft) was evaluated on Procedural success and survival. Open transcatheter aortic valve replacement (TAVI-in-homograft) on cardiopulmonary bypass was safely performed in a patient with a heavily calcified homograft, with the patient remaining asymptomatic at 14 months.
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