Key result
Transcatheter double valve implantation (TAVR and V-i-V TMVR) improved symptoms to NYHA class I-II and maintained good valve function at 6-month follow-up in a high-risk 59-year-old patient.
Why the study?
Combined TAVR and valve-in-valve TMVR is a rare procedure compared with surgical therapy, particularly in younger patients.
Case Report (n=1)
Combined transapical TAVR and valve-in-valve TMVR using SAPIEN 3 valves is feasible and can yield good mid-term clinical and echocardiographic outcomes in high-risk patients.
BACKGROUND: Transcatheter aortic valve replacement (TAVR) in combination with a valve-in-valve (V-i-V) transcatheter mitral valve replacement (TMVR) is a rare procedure in comparison to surgical therapy especially in young patients. We report on a young patient at high surgical risk, receiving a double valve implantation with two S3 transcatheter heart valves. CASE SUMMARY: A 59-year-old female patient with two previous mitral valve replacements due to endocarditis and re-endocarditis experienced a new onset of severe mitral valve stenosis in combination with progredient aortic stenosis. She was admitted to the hospital with severe dyspnoea and intermittent non-invasive ventilation [New York Heart Association (NYHA) III-IV]. An interventional transapical transcatheter double valve implantation was planned and carried out due to cardiac decompensation and high comorbidity preoperatively (STS score of 6.92). At 6-month follow-up, the patient presented herself in an improved condition with reduced symptoms (NYHA I-II), a good functional status of both valves and an advanced right and left ventricular function in the echocardiogram. DISCUSSION: Even in younger patients at high risk, a combined native TAVR and V-i-V TMVR procedure can be performed. In this case, a transcatheter SAPIEN 3 valve was transapically implanted with good clinical mid-term outcome at 6 months.
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Lutter et al. (2020) conducted a case report in Severe mitral valve stenosis and progredient aortic stenosis (n=1). Transcatheter double valve implantation (TAVR and V-i-V TMVR) with SAPIEN 3 valves was evaluated on Clinical and echocardiographic outcomes (NYHA class and valve function). Transcatheter double valve implantation (TAVR and V-i-V TMVR) improved symptoms to NYHA class I-II and maintained good valve function at 6-month follow-up in a high-risk 59-year-old patient.
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