Why the study?
Does transapical implantation of two transcatheter valves improve hemodynamics in a patient with severe aortic and mitral stenosis?
Does transapical implantation of two transcatheter valves improve hemodynamics in a patient with severe aortic and mitral stenosis?
This case report demonstrates the feasibility of simultaneous transapical transcatheter valve implantation in both aortic and mitral positions for high-risk patients.
Supports feasibility of dual transapical valve implantation in one high-risk patient; leaves open prospective validation of hemodynamics and outcomes.
Transcatheter valve implantation offers a new treatment modality to those patients whose general condition makes conventional surgery very risky. However, the transcatheter option has only been available for the aortic valve. We describe a case of a successful implantation of two Edwards SAPIEN(®) 26 and 29 mm transapical valves, respectively, in aortic and mitral positions, on a 74-year-old patient with severe aortic and mitral stenosis. The procedure progressed uneventfully. Predischarge echocardiogram showed a peak aortic gradient of 20 mmHg, mild periprosthetic regurgitation, peak and mean mitral gradients of 12 and 4, respectively, and moderate (II/IV) periprosthetic regurgitation. Indications for transapical valve implantation will rapidly increase in the near future. It is essential to individualize the treatment be applied for each patient, in order to optimize the success of the procedure.
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Neves et al. (2014) studied this question.
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