Key result
Simultaneous TAVR and PVL closure improves clinical status in a high-risk patient.
Why the study?
Early degeneration of bioprosthetic heart valves limits their use and presents treatment challenges in high-risk patients.
Case Report (n=1)
Case of premature bioprosthetic degeneration with paravalvular leak; leaves open durability concerns and need for prospective surveillance studies.
Concern for early degeneration limits the use of bioprosthetic heart valves. A 77-year-old man who underwent surgical aortic valve replacement at age 70 for severe aortic stenosis (AoS) presented with premature bioprosthesis degeneration and AoS recurrence. Transthoracic echocardiography demonstrated severe AoS and aortic regurgitation, a 30% ejection fraction, and pulmonary hypertension. Transesophageal echocardiography revealed that the aortic regurgitation was due to a 5-mm paravalvular leak (PVL). A high EuroScoreII excluded surgical treatment. Simultaneous transcatheter aortic valve replacement and PVL closure with an Occlutech PLD Square 5 Twist PVL closure device were performed with good results and improved clinical status.
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Balanescu et al. (2019) conducted a case report in Severe aortic stenosis recurrence, premature bioprosthesis degeneration, and paravalvular leak (n=1). Simultaneous transcatheter aortic valve replacement and paravalvular leak closure was evaluated on Clinical status. Simultaneous transcatheter aortic valve replacement and paravalvular leak closure was successfully performed in a high-risk 77-year-old man, resulting in improved clinical status.
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