Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency.
Male
Humans
Aged
Transcatheter Aortic Valve Replacement
/ adverse effects
Treatment Outcome
Aortic Valve
/ surgery
Aortic Valve Insufficiency
/ etiology
Heart Valve Prosthesis Implantation
/ adverse effects
Heart Transplantation
/ adverse effects
Aortic Valve Stenosis
/ surgery
Heart Valve Prosthesis
/ adverse effects
Risk Factors
Aortic valve
Aortic valve insufficiency
Heart transplantation
Kidney transplantation
Transcatheter aortic valve replacement
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
07 Oct 2023
07 Oct 2023
Historique:
received:
13
02
2023
accepted:
30
09
2023
medline:
9
10
2023
pubmed:
8
10
2023
entrez:
7
10
2023
Statut:
epublish
Résumé
Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicated and high risk due to the repeat sternotomy approach, and the immunosuppression in transplant patients. As heart transplant patients continue to live longer, patients are beginning to develop novo aortic pathology of the transplanted organ. In these patients, TAVR may be a valuable rescue therapy for those with de-novo aortic valve disease. Here, we present a single case of a 70-year-old man with a history of heart transplant 23 years prior complicated by severe sternal infection and subsequent removal of his sternum. Additionally, this patient had a recent history of kidney transplant due to renal cell carcinoma necessitating nephrectomy. He subsequently developed progressive symptomatic aortic insufficiency and underwent a successful TAVR to treat his new aortic disease. To our knowledge, this represents only the second case report of TAVR for severe aortic insufficiency and one of the first reports of TAVR in a multiple organ recipient. TAVR may represent an important rescue therapy for post-transplant valve pathologies instead of high-risk reoperative surgical aortic valve replacement.
Sections du résumé
BACKGROUND
BACKGROUND
Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicated and high risk due to the repeat sternotomy approach, and the immunosuppression in transplant patients. As heart transplant patients continue to live longer, patients are beginning to develop novo aortic pathology of the transplanted organ. In these patients, TAVR may be a valuable rescue therapy for those with de-novo aortic valve disease.
CASE PRESENTATION
METHODS
Here, we present a single case of a 70-year-old man with a history of heart transplant 23 years prior complicated by severe sternal infection and subsequent removal of his sternum. Additionally, this patient had a recent history of kidney transplant due to renal cell carcinoma necessitating nephrectomy. He subsequently developed progressive symptomatic aortic insufficiency and underwent a successful TAVR to treat his new aortic disease.
CONCLUSIONS
CONCLUSIONS
To our knowledge, this represents only the second case report of TAVR for severe aortic insufficiency and one of the first reports of TAVR in a multiple organ recipient. TAVR may represent an important rescue therapy for post-transplant valve pathologies instead of high-risk reoperative surgical aortic valve replacement.
Identifiants
pubmed: 37805477
doi: 10.1186/s13019-023-02407-x
pii: 10.1186/s13019-023-02407-x
pmc: PMC10560406
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
274Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
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