Thorac Cardiovasc Surg 2011; 59(8): 503-506
DOI: 10.1055/s-0030-1270995
Case Reports
Cardiovascular
© Georg Thieme Verlag KG Stuttgart · New York

Dislocation of a Transapically Implanted Aortic Valve Prosthesis with a Functionally Bicuspid Aortic Valve and Ascending Aortic Aneurysm

T. Schroeter1 , S. Subramanian1 , S. Lehmann1 , J. Kempfert2 , M. Misfeld1 , F. W. Mohr1 , M. A. Borger1
  • 1Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
  • 2Department of Cardiac Surgery, Heart Center Bad Nauheim, Bad Nauheim, Germany
Further Information

Publication History

received December 28, 2010 resubmitted February 2, 2011

accepted February 10, 2011

Publication Date:
20 April 2011 (online)

Abstract

In recent years, catheter-based aortic valve interventions have become established procedures for the treatment of high-risk and advanced age patients with aortic valve pathologies. One of the limitations of the widespread applicability of this procedure is the annulus size. Until recently, no prosthesis was available to treat patients with a large annulus. We report on a patient with high-grade aortic stenosis (AS) and a 27-mm annulus, who underwent transapical implantation (TAP) of an Edwards SAPIEN® 29-mm prosthesis (Edwards LifeScience, Irvine, CA, USA). Due to insufficient dilation of his heavily calcified, functionally bicuspid aortic valve leaflets during balloon aortic valvuloplasty (BAV), the TAP prosthesis did not anchor adequately. This was determined during follow-up as he developed progressive aortic insufficiency and orthopnea, and an echocardiography revealed that the valve had been displaced into the LVOT. A conventional aortic valve replacement and ascending aorta replacement were performed, at which time the TAP prosthesis was removed. The patient recovered uneventfully, and was discharged with a well-functioning aortic bioprosthetic valve and in good general condition.

References

Dr. Thomas Schroeter, MD

Department of Cardiac Surgery
Heart Center Leipzig

Struempellstrasse 39

04289 Leipzig

Germany

Phone: +49 3 41 86 50

Fax: +49 34 18 65 14 53

Email: thomas-schroeter@gmx.de