HEART Team in trouble: valve-in-valve implantation?
█ Case report
Kracskó Bertalan1, Kertész Attila1, Vajda Gusztáv1, Jenei Csaba1, Rácz Ildikó1, Szerafin Tamás2, Szokol Miklós1, Balogh Ágnes1, Csanádi Zoltán1, Bódi Annamária1
Debreceni Egyetem ÁOK,
1Kardiológiai és Szívsebészeti Intézet, Kardiológiai Tanszék,
2Kardiológiai és Szívsebészeti Intézet, Szívsebészeti Tanszék, Debrecen
In recent years, transcatheter aortic valve implantation (TAVI) gives the possibility to treat patients with significant aortic valve disease with high preoperative mortality risk.
On 17th of May, 2017 79 years old female patient was referred to our Institute because of the possibility of biological valve (25 mm of Stentless Pericarbon Freedom in 2003) endocarditis after a two week observation in a local hospital where she was admitted with recurrent fever, cough and aortic regurgitation detected by echocardiography. A mobile vegetation, proved by traditional transoesophageal echocardiography, suggested artificial valve endocarditis. 3D TEE recordings have also raised the possibility of the rupture of non-coronary cusp. According to detailed analysis, the partial rupture of the non-coronary cusp was proven with severe aortic valve insufficiency (vena contracta area: 1.2 cm2) without vegetation. Regarding the high preoperative surgical risk, Heart Team decided to go through valve-in-valve TAVI, which was successfully performed. Before emission well-functioning valve was visualized by control echocardiography.