Key result
Balloon redilation of a coarctation stent followed by transcatheter valve-in-valve aortic valve replacement successfully reduced the peak-to-peak transvalvular gradient from 60 mm Hg to 10 mm Hg.
Why the study?
With the widespread use of TAVR, cases associated with untreated or treated coarctation of aorta pose specific clinical challenges.
Case Report (n=1)
No
A single-stage transfemoral procedure involving coarctation stent redilation and valve-in-valve TAVR with a self-expanding valve is feasible and effective in treating combined recoarctation and degenerated aortic bioprosthesis.
Supports feasibility of balloon dilation for underexpanded CoA stents before TAVR; hypothesis-generating and leaves open durability and safety.
Combination of bicuspid aortic valve and coarctation of aorta (CoA) is common. With the widespread use of transcatheter aortic valve replacement (TAVR), cases associated with either untreated or treated CoA forms an important subset and pose specific challenges. We discuss a case of a patient with previously stented coarctation presenting with degenerated aortic bioprosthesis considered for TAVR due to porcelain aorta. The CoA stent was significantly underexpanded, which was balloon dilated, followed by TAVR with a self-expandable valve. We discuss the factors determining sequence of management, choice of CoA management, access and valve choice for TAVR in this subset.
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Sagar et al. (2025) conducted a case report in Degenerated aortic bioprosthesis and stented coarctation of aorta with restenosis (n=1). Balloon dilation of coarctation stent and transcatheter valve-in-valve aortic valve replacement was evaluated on Reduction in transvalvular and coarctation gradients. Balloon redilation of a coarctation stent followed by transcatheter valve-in-valve aortic valve replacement successfully reduced the peak-to-peak transvalvular gradient from 60 mm Hg to 10 mm Hg.
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