A new approach for severe aortic regurgitation in porcelain aorta with sutureless Perceval valve: A case report

Autor: Attilio Cotroneo, Marco Diena, Edmond Stelian, Gian Luca Martinelli, Diana C. Benea
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: International Journal of Surgery Case Reports
ISSN: 2210-2612
Popis: Highlights • Pure AR associated with porcelain aorta can be treated with the sutureless Perceval valve. • The sutureless Perceval valve does not at all require sutures for fixation. • The nitinol stent allows excellent fixation even in an elliptic calcified annulus. • Self-expandable aortic valves are effective in the treatment of pure AR.
Introduction The association of pure aortic regurgitation and porcelain aorta represents a challenging situation. In the Transcatheter Aortic Valve Implantation (TAVI) era, porcelain aorta (PA) becomes an additional risk for patient treatment and sometimes serves as the primary indication for the TAVI approach, even in low-risk patients. Devices currently on the market are not yet validated for the treatment of pure aortic regurgitation (AR) in PA and mid/long-term results are still not available. Furthermore, small calcified sinotubular junction and the association of small Valsalva sinus with low origin of coronaries ostia represent a relative contraindication of TAVI. Presentation of case We report a case of severe symptomatic AR associated with a PA in a patient successfully treated with a sutureless Perceval valve. Discussion The sutureless Perceval valve may represent an excellent option. This valve requires less manipulation of the ascending aorta and no manipulation of the aortic annulus except for the aortic valve leaflets removal. Furthermore, it can be implanted also in a small and calcified sino-tubular junction because the valve is collapsible before the implant. Conclusion The present case represents a proof that self-expandable cardiac valve technology can be employed to treat, either by surgery or by catheter, selected cases of AR. We have observed an excellent mid term result with no paravalvular leak at 2 years.
Databáze: OpenAIRE