January 1, 2011Open Access
Prosthetic Aortic Valve Stenosis in End-Stage Renal Failure
Key Result
Maintenance hemodialysis in a 79-year-old woman with a previously stable bioprosthetic aortic valve coincided with rapid progression of prosthetic valve stenosis requiring a second replacement.
Key Points
- To investigate the effect of hemodialysis on the progression of prosthetic aortic valve stenosis in patients with end-stage renal failure.
- Descriptive case report of a 79-year-old female with a history of bioprosthetic aortic valve replacement and end-stage renal failure.
- Observation of clinical progression coinciding with initiation of hemodialysis and subsequent management through second valve replacement.
- Patient experienced stable prosthetic valve area for 6 years post-replacement, followed by progressive stenosis after starting hemodialysis.
- Post-second valve replacement, patient showed resolution of symptoms.
- Findings suggest hemodialysis may accelerate prosthetic aortic valve stenosis progression.
Study Design
Type
Case Report (n=1)
Structured PICO
Does end-stage renal failure and hemodialysis accelerate the progression of prosthetic aortic valve stenosis in patients with bioprosthetic valves?
P
Population
79-year-old female with end-stage renal failure on maintenance hemodialysis and a bioprosthetic aortic valve implanted 8 years prior
I
Intervention
Maintenance hemodialysis
O
Outcome
Progression of prosthetic aortic valve stenosis
End-stage renal failure and hemodialysis may accelerate the progression of bioprosthetic aortic valve stenosis, suggesting a need for more frequent echocardiographic surveillance in this population.
Abstract
Although renal failure is one of the known comorbidities associated with rapid progression of aortic stenosis, it is unclear whether hemodialysis alters the progression of prosthetic aortic valve stenosis. We describe a 79-year-old female who underwent bioprosthetic aortic valve replacement 8 years ago with stable prosthetic valve area for the initial 6 years. In the last two years, coinciding with the initiation of maintenance hemodialysis, she developed progressive prosthetic valve stenosis to the point of clinical decompensation. She underwent a second prosthetic aortic valve replacement with symptom resolution. This case suggests that circulating milieu in end-stage renal failure and dialysis can accelerate the progression of prosthetic aortic valve stenosis. More frequent clinical followup and surveillance echocardiogram for dialysis patients with bioprosthetic aortic valve may facilitate timely management of valvular stenosis.