Publication Date
4-1-2017
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-15-5602
PMID
28461798
Publication Date(s)
April 2017
Language
English
PMCID
PMC5408626
PubMedCentral® Posted Date
4-1-2017
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Aortic valve/abnormalities/pathology, aortic valve stenosis/therapy, cardiac catheterization/instrumentation, heart defects, congenital/complications, heart valve diseases, heart valve prosthesis implantation/methods
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient.
A 31-year-old woman with Turner syndrome—who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks—presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use. Postdeployment angiography and transesophageal echocardiography and aortography revealed no aortic insufficiency.
Transcatheter aortic valve replacement for unicuspid aortic valve stenosis is technically feasible. Before implantation, particular attention should be paid to the interplay between the large single leaflet, coronary ostia, and stented valve, to select the correct size and position of the device. Some degree of intraoperative aortic migration should be anticipated.