Why the study?
Prior TAVI may complicate minimally invasive mitral valve surgery when endoaortic balloon occlusion (EABO) is considered, and guidance for EABO after TAVI remains limited.
Population
56-year-old woman with radiation-induced multivalvular disease and prior balloon-expandable TAVI
Design
Case report
Answers are grounded in this paper and cite their sources.
Reports successful endoaortic balloon occlusion during minimally invasive mitral valve replacement after TAVI, indicating feasibility when ascending aortic anatomy is suitable.
BACKGROUND: Prior transcatheter aortic valve implantation (TAVI) may complicate minimally invasive mitral valve surgery when endoaortic balloon occlusion (EABO) is considered. Guidance for EABO after TAVI remains limited. CASE SUMMARY: A 56-year-old woman with radiation-induced multivalvular disease underwent staged transfemoral balloon-expandable TAVI and coronary revascularization, followed by minimally invasive mitral valve replacement using EABO. Pre-TAVI computed tomography identified a potential ascending-aortic landing zone, and continuous TEE confirmed balloon positioning above the TAVI frame. EABO achieved complete aortic occlusion without migration, frame contact, or evidence of cerebral malperfusion. DISCUSSION: Prior balloon-expandable TAVI may not preclude EABO in carefully selected patients with favorable ascending-aortic anatomy. Imaging-based selection, continuous TEE surveillance, and controlled inflation are central to safety. TAKE-HOME MESSAGE: Prior balloon-expandable TAVI does not preclude EABO in selected patients with a suitable ascending-aortic landing zone.
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Agostini et al. (2026) studied this question.
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