Transapical aortic valve and mitral valve in ring prosthesis implantation – a new advance in transcatheter procedures

• Published in: Interactive cardiovascular and thoracic surgery 2014-08, Vol.19 (2), p.344-346
• Main Authors: Neves, Paulo C., Paulo, Nelson Santos, Gama, Vasco, Vouga, Luís
• Format: Article
• Language: English
• Subjects: Aged; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - therapy; Bioprosthesis; Cardiac Catheterization - instrumentation; Echocardiography, Three-Dimensional; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - methods; Humans; Male; Mitral Valve Annuloplasty - instrumentation; Mitral Valve Annuloplasty - methods; Mitral Valve Stenosis - complications; Mitral Valve Stenosis - diagnosis; Mitral Valve Stenosis - physiopathology; Mitral Valve Stenosis - therapy; Prosthesis Design; Radiography, Interventional; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivu137

Transcatheter valve implantation offers a new treatment modality to those patients whose general condition makes conventional surgery very risky. However, the transcatheter option has only been available for the aortic valve. We describe a case of a successful implantation of two Edwards SAPIEN® 26 and 29 mm transapical valves, respectively, in aortic and mitral positions, on a 74-year-old patient with severe aortic and mitral stenosis. The procedure progressed uneventfully. Predischarge echocardiogram showed a peak aortic gradient of 20 mmHg, mild periprosthetic regurgitation, peak and mean mitral gradients of 12 and 4, respectively, and moderate (II/IV) periprosthetic regurgitation. Indications for transapical valve implantation will rapidly increase in the near future. It is essential to individualize the treatment be applied for each patient, in order to optimize the success of the procedure.