Key result
Transfemoral TAVR achieves 6-month symptomatic and hemodynamic improvement in achondroplasia despite post-procedural AV block.
Why the study?
Transcatheter aortic valve replacement can be challenging in patients with achondroplasia because of small annuli and vascular-access constraints.
Case Report (n=1)
No
Transfemoral TAVR with a self-expanding valve and deep deployment strategy is feasible and achieves good hemodynamic and symptomatic outcomes at 6 months in a patient with achondroplasia, small annular anatomy, and minimally calcified severe aortic stenosis, albeit with a risk of conduction block requiring permanent pacing.
May inform TAVR planning in achondroplasia with small annuli; hypothesis-generating for deeper deployment strategies in low coronary height.
Transcatheter aortic valve replacement can be challenging in achondroplasia because of small annuli and vascular-access constraints. We report transfemoral transcatheter aortic valve replacement in a 77-year-old Jehovah's Witness woman with a very small annulus, low left coronary height, and minimally calcified severe aortic stenosis. A 23-mm Evolut FX+ valve (Medtronic) was selected by computed tomography sizing (16% oversizing). A deeper deployment strategy was chosen to mitigate coronary obstruction risk; final implantation depth was approximately 7.4 mm. The deeper position may have contributed to left bundle branch block with 2:1 atrioventricular block requiring permanent pacing. Hemodynamics were excellent, with sustained 6-month symptomatic improvement.
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Abdulmohsin Ahmadjee (2026) conducted a case report in Minimally calcified severe aortic stenosis in achondroplasia with small annular anatomy (n=1). Transfemoral transcatheter aortic valve replacement (23-mm Evolut FX+ valve) was evaluated on Hemodynamics and symptomatic improvement at 6 months. Transfemoral TAVR with a 23-mm Evolut FX+ at 7.4 mm depth yielded excellent hemodynamics and 6-month symptomatic improvement in achondroplasia, though 2:1 AV block required permanent pacing.
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