Transcatheter aortic valve implantation in a patient with two severe conditions: aortic stenosis and colon cancer

Abstract

An octogenarian female patient, admitted for heart failure secondary to severe aortic stenosis decompensated by atrial fibrillation, with a high ventricular response. When clinically compensated, she was discharged on oral anticoagulation with a direct-acting anticoagulant, for outpatient scheduling of a transcatheter implantation of aortic valve bioprosthesis. She was readmitted early due to low digestive bleeding secondary to locally advanced stenosing colon cancer. After discussion with the Heart Team and the oncology team, a transcatheter implantation of aortic valve bioprosthesis was the treatment chosen, followed by a colectomy 1 week later. She evolved clinically stable with early discharge from hospital, on oral anticoagulation with a direct-acting anticoagulant. In the 6-month follow-up, she remained asymptomatic from the cardiovascular point of view and with no recurrence of the low digestive tract bleeding.

Trends and Outcomes of TAVI and SAVR in Cancer and Noncancer Patients

“…This contrasts with the limited data available from the case reports, which showed favorable outcomes with TAVI in patients with CRC. 16 , 17 Similar trends were observed in patients with breast cancer, where older adults had a significantly higher risk of MACE and mortality compared with both younger patients undergoing TAVI, as well as those of the same age group undergoing SAVR. This could hypothetically be explained by the relatively higher incidence of prior exposure to therapeutic radiation in older adults, causing significant fibrosis and dystrophic calcifications of the aortic valve.…”