Publish in this journal
Journal Information
Vol. 73. Issue 1.
Pages 84 (January 2020)
Share
Share
Download PDF
More article options
Vol. 73. Issue 1.
Pages 84 (January 2020)
Image in cardiology
Full text access
Degenerated aortic self-expanding prosthesis: percutaneous valve-in-valve implantation
Prótesis autoexpandible degenerada: implante percutáneo aórtico valve-in-valve
Visits
...
Javier Suárez de Lezo?
Corresponding author
jslht@yahoo.es

Corresponding author:
, Manuel Pan, Miguel Romero
Servicio de Cardiología, Hospital Universitario Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

The patient was a 71-year-old man with severe aortic stenosis and coronary artery disease diagnosed in 2008. At the time, he had intermediate surgical risk but nevertheless refused surgery as a therapeutic option. Percutaneous revascularization was therefore undertaken, with implantation of a 26-mm CoreValve aortic prosthesis. The patient was free of symptoms with stable gradients until 2016, when the gradients started to increase, and symptoms reappeared in November 2017. Computed tomography angiography and ultrasound study showed signs of prosthesis degeneration, leaflet calcification (Figure 1A), leaflet thickening (Figures 1B and C) and increased gradient (Figure 1C). When the patient was aged 81 years, a 26-mm CoreValve Evolute Pro was successfully implanted in the existing prosthesis. Figure 2 (TAVI, transcatheter aortic valve implantation) shows details of the procedure and the hemodynamic changes in the aorta (Ao), left ventricle (LV), and pulmonary artery (PA). It has been shown that surgical biological prostheses that have undergone degeneration can be successfully treated with percutaneous aortic prostheses. However, there is no information on percutaneous prosthesis degeneration after 10 years, given that survival in recipients of such prostheses is lower and so such events are rare. To our knowledge, this is the first published case of a self-expanding prosthesis with degeneration 10 years after implantation that was treated with another percutaneous prosthesis. It demonstrates that this is a feasible and safe approach. If outcome is confirmed, this case could help to extend the indication for percutaneous prostheses to patients with intermediate risk.

Figure 1
(0.18MB).
Figure 2
(0.21MB).
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?