Bioprosthetic Valve Fracture for Early Severe Prosthesis Mismatch After SAVR.

We present a case of a 41-year-old male (body surface area, 2.3 m²) who presented 4 months after SAVR with a 21 mm surgical valve (Magna Ease, true inner diameter, 19 mm) with severe PPM (mean gradient, 43 mm Hg) despite normal functioning valvular prosthetic leaflets, associated with debilitating symptoms. This patient was deemed high risk by the heart team, and was successfully treated with TAV in SAV (26 mm Evolut R) and concomitant high-pressure bioprosthetic valve fracture (BVF) with a 22 mm high-pressure balloon. The patient tolerated the procedure well; mean gradient was 5 mm Hg post BVF and prompt resolution of symptoms was seen. His postprocedure recovery was uneventful and his symptoms resolved, allowing him to return to work within a week of his hospital discharge. BVF associated with TAV in SAV appears to be a feasible approach for treatment of severe symptomatic PPM even in the early postoperative period with otherwise normally functioning prosthesis. PMID: 32610271 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research