Key result
TAVR using a 29 mm Edwards-SAPIEN 3 valve was successfully performed in an 80-year-old man with severe bicuspid aortic stenosis and an aortic annulus size exceeding manufacturer recommendations.
Case Report (n=1)
No
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This case report describes the consideration of TAVR using a 29 mm Edwards-SAPIEN valve in a patient with severe bicuspid aortic stenosis and an extremely large annulus beyond manufacturer recommendations.
A patient with severe calcific bicuspid aortic valve stenosis, revealed by Transthoracic Echocardiogram (TEE), was markedly symptomatic with recurrent decompensation of diastolic heart failure. TEE also revealed moderate insufficiency with large annulus measurements beyond the parameters of currently available valve prostheses. Most valve companies initially declined to provide their device due to the size mismatch, raising concern about valve embolization and potential residual paravalvular leak (PVL). Ultimately, we decided that the calcification in both leaflets may be able to hold onto a 29 mm Edwards-SAPIEN valve, and after a prolonged informed consent the patient was considered for TAVR.
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A 2022 study conducted a case report in Severe calcific bicuspid aortic valve stenosis (n=1). Transcatheter Aortic Valve Replacement (TAVR) with 29 mm Edwards-SAPIEN 3 valve was evaluated on Procedural success. TAVR using a 29 mm Edwards-SAPIEN 3 valve was successfully performed in an 80-year-old man with severe bicuspid aortic stenosis and an aortic annulus size exceeding manufacturer recommendations.
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