This case highlights the risk of thrombotic restenosis following transapical aortic valve implantation, detectable by increasing mean gradients on echocardiography.
An 84-year-old woman underwent successful, minimallyinvasive, transapical aortic valve implantation (Edwards SAPIEN 23 mm) to address symptomatic high-grade aortic stenosis and logistic EuroScore of 22%. Echocardiographic control after 11 and 41 days demonstrated the valve in good position without relevant paravalvular leakage or aortic re-gurgitation. Mean gradients over aortic valve implant were 17 mm Hg and 19 mm Hg, respectively. At echocardiograph-ic follow-up at 6 and 8 months, mean gradient increased to
Trepels et al. (2009) studied this question.