Emergency transcatheter aortic valve replacement for surgical bioprosthesis structural valve degeneration: a case report_West China Medical Journal

Authors：

FANG Zhen ¹ , JI Jun ¹ , CHEN Shu ¹ , ZHANG Jing ¹ , CHEN Yong ² , BAO Ping ² ,  HE Shenghu ¹

1. Department of Cardiology, Northern Jiangsu People’s Hospital, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225000, P. R. China;
2. Department of Cardiac Function Examination, Northern Jiangsu People’s Hospital, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225000, P. R. China;

Corresponding author：

HE Shenghu, Email: yzhshys@163.com

Keywords：

Transcatheter aortic valve replacement; bioprosthesis structural valve degeneration; valve-in-valve

DOI：

10.7507/1002-0179.202110150

Video：

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“Valve-in-valve” technique is an effective method to treat the bioprosthesis structural valve degeneration. In this paper, an 82-year-old male patient with severe aortic valve regurgitation had underwent surgical aortic valve replacement. He had a bioprosthesis structural valve degeneration which caused severe aortic stenosis more than 3 years after surgery. His symptoms of chest distress and short breath were aggravated progressively, and not relieved by conventional treatment. As the deterioration in his unstabled circulation system, an emergency transcatheter aortic valve replacement was conducted for him. The operation was finally successful, the symptoms were relived significantly after operation, and then the follow-up indicated that he had a good recovery.

Citation： FANG Zhen, JI Jun, CHEN Shu, ZHANG Jing, CHEN Yong, BAO Ping, HE Shenghu. Emergency transcatheter aortic valve replacement for surgical bioprosthesis structural valve degeneration: a case report. West China Medical Journal, 2022, 37(4): 517-521. doi: 10.7507/1002-0179.202110150 Copy

1.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
2.	葛均波, 周达新, 潘文志, 等. 经皮主动脉瓣植入术一例及其操作要点. 中国介入心脏病学杂志, 2010, 18(5): 243-246.
3.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.
4.	Ferrari E. Transapical aortic ‘valve-in-valve’ procedure for degenerated stented bioprosthesis. Eur J Cardiothorac Surg, 2012, 41(3): 485-490.
5.	姜海滨. “瓣中瓣”技术在生物瓣膜衰败治疗上的应用. 心血管病学进展, 2013, 34(4): 561-564.
6.	Côté N, Pibarot P, Clavel MA. Incidence, risk factors, clinical impact, and management of bioprosthesis structural valve degeneration. Curr Opin Cardiol, 2017, 32(2): 123-129.
7.	Dvir D, Webb JG, Bleiziffer S, et al. Transcatheter aortic valve implantation in failed bioprosthetic surgical valves. JAMA, 2014, 312(2): 162-170.
8.	杨力凡, 潘文志, 张晓春, 等. 人工生物瓣膜结构性衰败后再次行经导管主动脉瓣置换一例. 中华心血管病杂志, 2021, 49(5): 507-509.
9.	陈鹏飞, 易俊霖, 唐亮, 等. 瓣中瓣技术在经导管主动脉瓣置入术中的应用3例报道. 中国介入心脏病学杂志, 2018, 26(11): 658-660.
10.	周达新, 潘文志, 管丽华, 等. 经导管瓣中瓣置入术治疗人工生物主动脉瓣反流一例. 中华心血管病杂志, 2013, 41(9): 800-801.
11.	Webb JG, Wood DA, Ye J, et al. Transcatheter valve-in-valve implantation for failed bioprosthetic heart valves. Circulation, 2010, 121(16): 1848-1857.
12.	Hirji SA, Percy ED, Zogg CK, et al. Comparison of in-hospital outcomes and readmissions for valve-in-valve transcatheter aortic valve replacement vs. reoperative surgical aortic valve replacement:a contemporary assessment of real-world outcomes. Eur Heart J, 2020, 41(29): 2747-2755.
13.	Sá MPBO, Van den Eynde J, Simonato M, et al. Valve-in-valve transcatheter aortic valve replacement versus redo surgical aortic valve replacement: an updated meta-analysis. JACC Cardiovasc Interv, 2021, 14(2): 211-220.
14.	Yao RJ, Simonato M, Dvir D. Optimising the haemodynamics of aortic valve-in-valve procedures. Interv Cardiol, 2017, 12(1): 40-43.
15.	Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med, 2010, 363(17): 1597-1607.
16.	李华俊, 刘先宝, 孔敏坚, 等. 经导管主动脉瓣置换围术期Impella辅助救治主动脉瓣反流一例. 中华心血管病杂志, 2021, 49(2): 179-181.
17.	Kolte D, Khera S, Vemulapalli S, et al. Outcomes following urgent/emergent transcatheter aortic valve replacement: insights from the STS/ACC TVT registry. JACC Cardiovasc Interv, 2018, 11(12): 1175-1185.
18.	姜正明, 李光照, 胡彩娜, 等. 急诊经导管主动脉瓣置换术治疗重度主动脉瓣狭窄的早期临床疗效分析. 华西医学, 2021, 36(11): 1522-1527.
19.	David TE, Feindel CM, Bos J, et al. Aortic valve replacement with Toronto SPV bioprosthesis: optimal patient survival but suboptimal valve durability. J Thorac Cardiovasc Surg, 2008, 135(1): 19-24.
20.	David TE, Ivanov J, Armstrong S, et al. Late results of heart valve replacement with the Hancock Ⅱ bioprosthesis. J Thorac Cardiovasc Surg, 2001, 121(2): 268-277.
21.	Poirer NC, Pelletier LC, Pellerin M, et al. 15-year experience with the Carpentier-Edwards pericardial bioprosthesis. Ann Thorac Surg, 1998, 66(6 Suppl): S57-S61.
22.	金沁纯, 潘文志, 张晓春, 等. 经导管主动脉瓣置换术中瓣中瓣技术的应用进展. 复旦学报(医学版), 2021, 48(2): 235-239.
23.	Isaacs AJ, Shuhaiber J, Salemi A, et al. National trends in utilization and in-hospital outcomes of mechanical versus bioprosthetic aortic valve replacements. J Thorac Cardiovasc Surg, 2015, 149(5): 1262-1269.
24.	武云龙, 王寅, 董念国. 瓣膜介入时代的思考—外科医生视角. 中国胸心血管外科临床杂志, 2021, 28(12): 1415-1419.

1. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
2. 葛均波, 周达新, 潘文志, 等. 经皮主动脉瓣植入术一例及其操作要点. 中国介入心脏病学杂志, 2010, 18(5): 243-246.
3. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.
4. Ferrari E. Transapical aortic ‘valve-in-valve’ procedure for degenerated stented bioprosthesis. Eur J Cardiothorac Surg, 2012, 41(3): 485-490.
5. 姜海滨. “瓣中瓣”技术在生物瓣膜衰败治疗上的应用. 心血管病学进展, 2013, 34(4): 561-564.
6. Côté N, Pibarot P, Clavel MA. Incidence, risk factors, clinical impact, and management of bioprosthesis structural valve degeneration. Curr Opin Cardiol, 2017, 32(2): 123-129.
7. Dvir D, Webb JG, Bleiziffer S, et al. Transcatheter aortic valve implantation in failed bioprosthetic surgical valves. JAMA, 2014, 312(2): 162-170.
8. 杨力凡, 潘文志, 张晓春, 等. 人工生物瓣膜结构性衰败后再次行经导管主动脉瓣置换一例. 中华心血管病杂志, 2021, 49(5): 507-509.
9. 陈鹏飞, 易俊霖, 唐亮, 等. 瓣中瓣技术在经导管主动脉瓣置入术中的应用3例报道. 中国介入心脏病学杂志, 2018, 26(11): 658-660.
10. 周达新, 潘文志, 管丽华, 等. 经导管瓣中瓣置入术治疗人工生物主动脉瓣反流一例. 中华心血管病杂志, 2013, 41(9): 800-801.
11. Webb JG, Wood DA, Ye J, et al. Transcatheter valve-in-valve implantation for failed bioprosthetic heart valves. Circulation, 2010, 121(16): 1848-1857.
12. Hirji SA, Percy ED, Zogg CK, et al. Comparison of in-hospital outcomes and readmissions for valve-in-valve transcatheter aortic valve replacement vs. reoperative surgical aortic valve replacement:a contemporary assessment of real-world outcomes. Eur Heart J, 2020, 41(29): 2747-2755.
13. Sá MPBO, Van den Eynde J, Simonato M, et al. Valve-in-valve transcatheter aortic valve replacement versus redo surgical aortic valve replacement: an updated meta-analysis. JACC Cardiovasc Interv, 2021, 14(2): 211-220.
14. Yao RJ, Simonato M, Dvir D. Optimising the haemodynamics of aortic valve-in-valve procedures. Interv Cardiol, 2017, 12(1): 40-43.
15. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med, 2010, 363(17): 1597-1607.
16. 李华俊, 刘先宝, 孔敏坚, 等. 经导管主动脉瓣置换围术期Impella辅助救治主动脉瓣反流一例. 中华心血管病杂志, 2021, 49(2): 179-181.
17. Kolte D, Khera S, Vemulapalli S, et al. Outcomes following urgent/emergent transcatheter aortic valve replacement: insights from the STS/ACC TVT registry. JACC Cardiovasc Interv, 2018, 11(12): 1175-1185.
18. 姜正明, 李光照, 胡彩娜, 等. 急诊经导管主动脉瓣置换术治疗重度主动脉瓣狭窄的早期临床疗效分析. 华西医学, 2021, 36(11): 1522-1527.
19. David TE, Feindel CM, Bos J, et al. Aortic valve replacement with Toronto SPV bioprosthesis: optimal patient survival but suboptimal valve durability. J Thorac Cardiovasc Surg, 2008, 135(1): 19-24.
20. David TE, Ivanov J, Armstrong S, et al. Late results of heart valve replacement with the Hancock Ⅱ bioprosthesis. J Thorac Cardiovasc Surg, 2001, 121(2): 268-277.
21. Poirer NC, Pelletier LC, Pellerin M, et al. 15-year experience with the Carpentier-Edwards pericardial bioprosthesis. Ann Thorac Surg, 1998, 66(6 Suppl): S57-S61.
22. 金沁纯, 潘文志, 张晓春, 等. 经导管主动脉瓣置换术中瓣中瓣技术的应用进展. 复旦学报(医学版), 2021, 48(2): 235-239.
23. Isaacs AJ, Shuhaiber J, Salemi A, et al. National trends in utilization and in-hospital outcomes of mechanical versus bioprosthetic aortic valve replacements. J Thorac Cardiovasc Surg, 2015, 149(5): 1262-1269.
24. 武云龙, 王寅, 董念国. 瓣膜介入时代的思考—外科医生视角. 中国胸心血管外科临床杂志, 2021, 28(12): 1415-1419.

West China Medical Journal

Emergency transcatheter aortic valve replacement for surgical bioprosthesis structural valve degeneration: a case report

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