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Elbadawi A, Dayal Y, Kumbhani DJ. Repeat Transcatheter Aortic Valve Implantation: The Importance of Getting it Right the First Time Round! JACC. ASIA 2024; 4:40-43. [PMID: 38222262 PMCID: PMC10782399 DOI: 10.1016/j.jacasi.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Affiliation(s)
- Ayman Elbadawi
- Christus Good Shepherd Medical Center, Longview, Texas, USA
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Takei Y, Suzuki R, Shibasaki I, Tokura M, Nasuno T, Yazawa H, Wada M, Saito F, Toyoda S, Fukuda H. Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report. Surg Case Rep 2023; 9:155. [PMID: 37665417 PMCID: PMC10477146 DOI: 10.1186/s40792-023-01739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Transcatheter valve replacement is contraindicated in patients with active infective endocarditis. However, few reports suggest that it could be beneficial for high-risk surgical patients with healed infective endocarditis. Here, we report a case of a surgical transcatheter aortic valve in a patient with healed repeated prosthetic valve endocarditis using a stentless valve. CASE PRESENTATION A 79-year-old female who underwent the Bentall procedure using a stentless valve and coronary artery bypass grafting for annuloaortic ectasia 22 years ago was hospitalized for stage II bioprosthetic valve failure. The patient had a history of prosthetic valve endocarditis three times: the first and second prosthetic valve endocarditis occurred 15 years ago, and the third prosthetic valve endocarditis occurred 3 years ago. The causative organisms were Campylobacter fetus and Enterococcus faecalis. With appropriate antibiotic therapy, the lesion was localized and healed completely without valve destruction; however, the patient developed rapid aortic regurgitation. Based on a review of the patient's history of prosthetic valve endocarditis, the absence of signs of infection, and clinical findings of transesophageal echocardiography and computed tomography, a diagnosis of structural valve deterioration with healed infective endocarditis was made. Subsequently, a transcatheter aortic valve in a surgical aortic valve using a balloon-expandable type was performed, because the patient had a high surgical risk of 12.7%. The patient's postoperative course was uneventful. At the 1-year follow-up, there were no signs of infection or valve abnormalities. CONCLUSIONS Transcatheter valve replacement can be a treatment option for high-risk surgical patients with healed limited lesions in infective endocarditis.
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Affiliation(s)
- Yusuke Takei
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan.
| | - Ryujiro Suzuki
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Ikuko Shibasaki
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Michiaki Tokura
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Takahisa Nasuno
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Hiroko Yazawa
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Mayo Wada
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Fumiya Saito
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Hirotugu Fukuda
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
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Bavry AA, Kumbhani DJ. As Patients Live Longer, Are We on the Cusp of a New Valve Epidemic? J Am Coll Cardiol 2021; 77:15-17. [PMID: 33413935 DOI: 10.1016/j.jacc.2020.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/24/2022]
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Patel KV, Omar W, Gonzalez PE, Jessen ME, Huffman L, Kumbhani DJ, Bavry AA. Expansion of TAVR into Low-Risk Patients and Who to Consider for SAVR. Cardiol Ther 2020; 9:377-394. [PMID: 32875469 PMCID: PMC7584721 DOI: 10.1007/s40119-020-00198-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Indexed: 12/15/2022] Open
Abstract
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis (AS) over the last decade. The results of the Placement of Aortic Transcatheter Valves (PARTNER) 3 and Evolut Low Risk trials demonstrated the safety and efficacy of TAVR in low-surgical-risk patients and led to the approval of TAVR for use across the risk spectrum. Heart teams around the world will now be faced with evaluating a deluge of younger, healthier patients with severe AS. Prior to the PARTNER 3 and Evolut Low Risk studies, this heterogenous patient population would have undergone surgical aortic valve replacement (SAVR). It is unlikely that TAVR will completely supplant SAVR for the treatment of severe AS in patients with a low surgical risk, as SAVR has excellent short- and long-term outcomes and years of durability data. In this review, we outline the critical role that SAVR will continue to play in the treatment of severe AS in the post-PARTNER 3/Evolut Low Risk era.
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Affiliation(s)
- Kunal V Patel
- Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA
| | - Wally Omar
- Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA
| | - Pedro Engel Gonzalez
- Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA
| | - Michael E Jessen
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Texas, USA
| | - Lynn Huffman
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Texas, USA
| | - Dharam J Kumbhani
- Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA
| | - Anthony A Bavry
- Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA.
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