Successful percutaneous implantation of Symetis ACURATE neo transcatheter aortic bioprosthesis in a patient with existing mechanical mitral valve

نویسندگان

  • Sina Ali
  • Yakup Alsancak
  • Mustafa Duran
  • Mehmet Bilge
چکیده

A 73-year old woman who had previous mechanical mitral valve replacement (MVR) presented with worsening symptoms of dyspnea. Echocardiographic evaluation revealed severe aortic stenosis with calcified trileaflet aortic valve (aortic valve area was 0.9 cm2, mean gradient was 42 mm Hg with 45% ejection fraction). Society of Thoracic Surgeons score of the patient was 8.9%, mean logistic European system for cardiac operative risk evaluation was 23.8%. After multi-disciplinary discussion of Heart Team, patient was taken for transcatheter aortic valve replacement (TAVI) using Symetis ACURATE TF (SATF) (Symetis SA, Ecublens, Switzerland) via transfemoral approach. During the procedure, medium-sized valve was positioned for deployment following balloon valvuloplasty. After unsheathing of upper crown and opening of stabilization arches, full deployment of valve was performed through unsheathing of lower crown (Fig. 1, 2; Video 1–3). After implantation, final aortography showed no paravalvular leak (Fig. 3). Patient was discharged at postoperative day 2 and follow-up echocardiography demonstrated excellent aortic and mitral prosthesis function after 30 days. It is well known that presence of mechanical mitral valve within aorto-mitral curtain not only makes proper positioning challenging, but also makes procedure difficult with life-threatening complications such as malposition and embolization of device, or post-procedural dysfunction of mitral prosthesis due to damage. Although SATF has been designed as novel prosthesis for TAVI, there is still paucity of data in the literature for patients with history of MVR who have undergone TAVI. According to the literature, most procedures are still performed with first-generation devices. Flexible stabilization arches, upper, and lower crowns allow cover to remain in proper position. Unlike other devices, SATF has very low radial force and facilitates optimal implantation with only a few millimeters protruding in left ventricular outflow tract or annulus of mechanical mitral prosthetic valves during procedure. In our patient, SATF valve showed promising results in terms of safety and feasibility.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Transapical aortic valve implantation using a Symetis Acurate self-expandable bioprosthesis: initial outcomes of 10 patients

INTRODUCTION Transapical aortic valve implantation (TA-AVI) has been widely introduced for treatment of patients with severe aortic stenosis in the last decade. Here we report our first clinical experience with 10 patients using the second-generation transapical Symetis Acurate TA aortic valve designed for transapical implantation. AIM To evaluate the results of transapical access in transcat...

متن کامل

The Self-Expanding Symetis Acurate Does Not Increase Cerebral Microembolic Load When Compared to the Balloon-Expandable Edwards Sapien Prosthesis: A Transcranial Doppler Study in Patients Undergoing Transapical Aortic Valve Implantation

OBJECTIVES The aim of this study was to quantify potential differences in count, frequency and pattern of high-intensity transient signals (HITS) during transapical transcatheter aortic valve implantation (TA-TAVI), by comparing the Symetis Acurate TA (SA) with the balloon-expandable Edwards Sapien XT (ES) system. BACKGROUND Recently, the Symetis Acurate TA revalving system has been introduce...

متن کامل

Transapical aortic valve implantation using a new self-expandable bioprosthesis (ACURATE TA™): 6-month outcomes.

OBJECTIVES The ACURATE TA(™) Aortic Bioprosthesis and Delivery System (Symetis S.A., Ecublens, Switzerland) is a new transcatheter aortic valve designed for transapical implantation. The six-month results from the completed first-in-man study are reported. METHODS The Symetis ACURATE TA(™) is composed of a porcine biological tissue valve attached to a self-expandable nitinol stent. It allows ...

متن کامل

Self-expandable transcatheter aortic valve implantation for aortic stenosis after mitral valve surgery.

OBJECTIVES Transcatheter aortic valve implantation has emerged as a valuable option to treat patients with symptomatic severe aortic stenosis, who are not being considered for surgery because of significant comorbidities. Concerns exist over treating patients who have previously undergone mitral valve surgery for possible interference between the percutaneous aortic valve and the mitral prosthe...

متن کامل

Emergency transapical mitral valve-in-valve implantation for bioprosthesis failure: transapical implantation of an Edwards Sapien-XT in a dysfunctional mitral bioprosthesis in a critical patient

Background: Valve-in-Valve (VIV) Transcatheter Aortic Valve Replacement (TAVR) is now the treatment of choice in high-surgical-risk patients with failing aortic bioprosthesis. Although less performed, VIV-Transcatheter Mitral Valve Replacement (TMVR) is a valid treatment option for selected high-risk patients with degenerated mitral bioprostheses. Several cases of elective ViVTAVR and -TMVR hav...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 16  شماره 

صفحات  -

تاریخ انتشار 2016