Tiara Valve Implantation in a Patient With Previously Implanted Mono-disk Mechanical Aortic Prosthesis

Semin Thorac Cardiovasc Surg. 2018 Summer;30(2):160-163. doi: 10.1053/j.semtcvs.2018.02.028. Epub 2018 Mar 5.

Abstract

Transcatheter mitral valve replacement with the Tiara valve can be performed in inoperable patients with severe functional regurgitation. Risk of left ventricular outflow tract obstruction can be prevented using preoperative 3D imaging and 3D-printed models. However, in the case of mono-disk mechanical prostheses previously implanted in aortic position (Bjork-Shiley), there is an additional risk of mechanical interference leading to reduced leaflet motion and aortic valve dysfunction. Hereafter, we describe the case of a patient with a 27-mm mono-disk mechanical aortic valve implanted in 1978, a EuroSCORE II of 18%, and a Society of Thoracic Surgeon score (mortality) of 16% who successfully underwent a transapical Tiara valve implantation.

Keywords: mechanical aortic valve; transapical procedure; transcatheter mitral valve implantation.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Aortic Valve / physiopathology
  • Aortic Valve / transplantation*
  • Cardiac Catheterization / instrumentation*
  • Cardiac Catheterization / methods
  • Echocardiography, Three-Dimensional
  • Echocardiography, Transesophageal
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology
  • Mitral Valve / transplantation*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Models, Anatomic
  • Models, Cardiovascular
  • Patient-Specific Modeling
  • Printing, Three-Dimensional
  • Prosthesis Design
  • Tomography, X-Ray Computed
  • Treatment Outcome