Transcatheter aortic valve replacement for a patient with bicuspid aortic valve stenosis characterized by leaflet thickening: a case report_West China Medical Journal

Authors：

ZHANG Yike , OU Yuanweixiang , WANG Zijie , WANG Xi , XU Yuanning ,  FENG Yuan ,  CHEN Mao

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

FENG Yuan, Email: ynotebook@hotmail.com; CHEN Mao, Email: hmaochen@vip.sina.com

Keywords：

Aortic stenosis characterized by leaflet thickening; Transcatheter aortic valve replacement; Bicuspid aortic valve; Aortic valvuloplasty

DOI：

10.7507/1002-0179.202003004

Video：

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Due to the lack of calcification of the aortic valve, it is difficult to provide effective support for the fixation of artificial valve in aortic stenosis characterized by leaflet thickening. There is a risk of postoperative perivalvular leakage and secondary valve implantation, which is widely regarded as a relative contraindication for transcatheter aortic valve replacement (TAVR). But aortic valvuloplasty and self-expanding transcatheter aortic valve has showed its safety and efficacy. This paper reports a patient with bicuspid aortic valve characterized by leaflet thickening treated with TAVR. After the operation, the patient’s symptom of exertional dyspnea was significantly improved, New York Heart Association class increased to Ⅱ, no perivalvular leakage was found, and the mean transaortic pressure gradient and the maximum aortic valve velocity decreased significantly.

Citation： ZHANG Yike, OU Yuanweixiang, WANG Zijie, WANG Xi, XU Yuanning, FENG Yuan, CHEN Mao. Transcatheter aortic valve replacement for a patient with bicuspid aortic valve stenosis characterized by leaflet thickening: a case report. West China Medical Journal, 2020, 35(4): 442-445. doi: 10.7507/1002-0179.202003004 Copy

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2.	Xiong TY, Feng Y, Liao YB, et al. Transcatheter aortic valve replacement in patients with non-calcific aortic stenosis. EuroIntervention, 2018, 13(15): e1756-e1763.
3.	Tops LF, Wood DA, Delgado V, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging, 2008, 1(3): 321-330.
4.	Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.
5.	Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
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7.	Roy D, Sharma R, Brecker SJ. Native aortic valve regurgitation: transcatheter therapeutic options. EuroIntervention, 2013(Suppl 9): S55-S62.
8.	Testa L, Latib A, Rossi ML, et al. CoreValve implantation for severe aortic regurgitation: a multicentre registry. EuroIntervention, 2014, 10(6): 739-745.
9.	Holzamer A, Husser O, Camboni D, et al. Transcatheter aortic valve implantation (TAVI) in aortic regurgitation: a case series of 6 patients. Thorac cardiovasc Surg, 2013: 61-OP203.
10.	Staubach S, Franke J, Gerckens U, et al. Impact of aortic valve calcification on the outcome of transcatheter aortic valve implantation: results from the prospective multicenter German TAVI registry. Catheter Cardiovasc Interv, 2013, 81(2): 348-355.
11.	Zhao ZG, Feng Y, Liao YB, et al. Reshaping bicuspid aortic valve stenosis with an hourglass-shaped balloon for transcatheter aortic valve replacement: a pilot study. Catheter Cardiovasc Interv, 2020(Suppl 1): 616-623.
12.	Tay ELW, Ngiam JN, Kong WK, et al. Management of severe aortic stenosis: the Singapore and Asian perspective. Singapore Med J, 2018, 59(9): 452-454.
13.	Mylotte D, Lefevre T, Søndergaard L, et al. Transcatheter aortic valve replacement in bicuspid aortic valve disease. J Am Coll Cardiol, 2014, 64(22): 2330-2339.
14.	Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: a patient level multicenter analysis. Int J Cardiol, 2015, 189: 282-288.

1. Bonow RO, Mann DL, Zipes DP, et al. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Elsevier Inc., 2012: 1468.
2. Xiong TY, Feng Y, Liao YB, et al. Transcatheter aortic valve replacement in patients with non-calcific aortic stenosis. EuroIntervention, 2018, 13(15): e1756-e1763.
3. Tops LF, Wood DA, Delgado V, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging, 2008, 1(3): 321-330.
4. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.
5. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
6. Holmes DR Jr, Mack MJ, Kaul S, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement.: developed in collabration with the American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Failure Society of America, Mended Hearts, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. J Thorac Cardiovasc Surg, 2012, 144(3): e29-e84.
7. Roy D, Sharma R, Brecker SJ. Native aortic valve regurgitation: transcatheter therapeutic options. EuroIntervention, 2013(Suppl 9): S55-S62.
8. Testa L, Latib A, Rossi ML, et al. CoreValve implantation for severe aortic regurgitation: a multicentre registry. EuroIntervention, 2014, 10(6): 739-745.
9. Holzamer A, Husser O, Camboni D, et al. Transcatheter aortic valve implantation (TAVI) in aortic regurgitation: a case series of 6 patients. Thorac cardiovasc Surg, 2013: 61-OP203.
10. Staubach S, Franke J, Gerckens U, et al. Impact of aortic valve calcification on the outcome of transcatheter aortic valve implantation: results from the prospective multicenter German TAVI registry. Catheter Cardiovasc Interv, 2013, 81(2): 348-355.
11. Zhao ZG, Feng Y, Liao YB, et al. Reshaping bicuspid aortic valve stenosis with an hourglass-shaped balloon for transcatheter aortic valve replacement: a pilot study. Catheter Cardiovasc Interv, 2020(Suppl 1): 616-623.
12. Tay ELW, Ngiam JN, Kong WK, et al. Management of severe aortic stenosis: the Singapore and Asian perspective. Singapore Med J, 2018, 59(9): 452-454.
13. Mylotte D, Lefevre T, Søndergaard L, et al. Transcatheter aortic valve replacement in bicuspid aortic valve disease. J Am Coll Cardiol, 2014, 64(22): 2330-2339.
14. Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: a patient level multicenter analysis. Int J Cardiol, 2015, 189: 282-288.

West China Medical Journal

Transcatheter aortic valve replacement for a patient with bicuspid aortic valve stenosis characterized by leaflet thickening: a case report

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