Key result
Transcatheter aortic valve implantation was successfully performed to treat recurrent severe aortic stenosis 6 years after aortic valve neocuspidization in an 80-year-old woman.
Why the study?
Although reoperation risk is low following aortic valve neocuspidization, reports on the deterioration of the reconstructed valve have been lacking.
Case Report (n=1)
TAVI is a feasible and potentially suitable approach for treating structural deterioration and restenosis after aortic valve neocuspidization, avoiding high-risk redo open-heart surgery in elderly patients.
May support TAVI feasibility after AVNeo failure; leaves open durability and broader applicability.
BACKGROUND: Aortic valve neocuspidization (AVNeo), a novel surgical procedure used in the treatment of aortic valve diseases, including aortic stenosis (AS), involves the replacement of three aortic valve cusps by glutaraldehyde-treated autologous pericardium. Although reoperation risk is low, no case report on the deterioration of the AVNeo has yet been published. CASE SUMMARY: An 80-year-old woman who underwent AVNeo for severe degenerative tricuspid AS 6 years previously complained of shortness of breath. Echocardiographic assessment revealed the reconstructed aortic valve leaflet was elongated, thickened, and marginally calcified resulting in recurrent severe AS. Transcatheter aortic valve implantation using balloon-expandable transcatheter heart valve was successfully performed. DISCUSSION: To our knowledge, this is the first case report regarding the structural deterioration of the AVNeo resulting in restenosis 6 years after the first surgery. Transcatheter aortic valve implantation is possibly a suitable approach for post-procedural recurrence after AVNeo to avoid redo open-heart surgery which would be of prohibitive risk especially in an elderly population.
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Tada et al. (2019) conducted a case report in recurrent severe aortic stenosis (n=1). Transcatheter aortic valve implantation was evaluated. Transcatheter aortic valve implantation was successfully performed to treat recurrent severe aortic stenosis 6 years after aortic valve neocuspidization in an 80-year-old woman.
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