Unequal quadricuspid aortic valve stenosis treated with transcatheter aortic valve replacement

Fukui, Tomoki; Kitabayashi, Katsukiyo; Ogasawara, Nobuyuki; Hasegawa, Shin

doi:10.1093/ehjcr/ytaa314

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…Blanke and his colleagues successfully implanted a 26 mm Edwards Sapien THV (Edwards Lifesciences, Irvine, CA, USA) via a transapical approach in a 79 year-old patient with AS-QAV. In the decade since, only a few successful cases of TAVR for the treatment of patients with QAV have been reported (Table 4) (10)(11)(12)(13)(14)(19)(20)(21)(22)(23)(24)(25)(26). The pathological types of these patients included AS and AR.…”

Section: Discussionmentioning

confidence: 99%

“…It is now increasingly applied in different valvular malformations, including bicuspid aortic valves, native pure AR, valvein-valve procedures for degenerated bioprostheses, and more complex anatomical characteristics. However, only a few cases of stenosed or regurgitant QAV treated successfully with TAVR have been reported (10)(11)(12)(13)(14). Our institution has more than 10 years of experience with TAVR and other structural heart interventions.…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter aortic valve replacement in patients with quadricuspid aortic valve in a single center

Liu

Zhai

et al. 2022

Front. Cardiovasc. Med.

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BackgroundQuadricuspid aortic valve (QAV) is a rare congenital malformation that can present with aortic regurgitation or aortic stenosis (AS)), requiring surgical treatment. Transcatheter aortic valve replacement (TAVR) is an alternative treatment for older patients and its prognosis for QAV therapy remains challenging. We sought to examine our early experience with TAVR in patients with QAV.Materials and methodsProspectively collected data were retrospectively reviewed in patients with QAV undergoing TAVR in our institution.ResultsFive patients with QAV and AR or AS were treated with TAVR between January 2016 and January 2022. The mean age was 73.8 years (range 69–82 years), and the median Society of Thoracic Surgeons score was 7.51% (range 2.668–18.138%). Two patients had type B and three had either type A, D, or F according to the Hurwitz and Roberts classification for QAV. Four patients with pure aortic regurgitation underwent transapical TAVR using the J-Valve system, and the patient with severe AS underwent transfemoral TAVR using the Venus-A system. Procedural success was achieved in all five patients. Trivial paravalvular leak was only detected in one case after the procedure, and one patient received a permanent pacemaker due to high-degree atrioventricular block three days later. The median follow-up period was 18 (12–56) months. After discharge, no deaths occurred during the 1 year follow-up. All patients improved by ≥1 New York Heart Association functional class at 30 days; four patients were in functional class ≤II later in the follow-up period. All patients’ heart failure symptoms improved considerably.ConclusionOur early experience with TAVR in QAV demonstrates these procedures to be feasible with acceptable early results. Further follow-up is necessary to determine the long-term outcomes of this modality.Clinical trial registration[ClinicalTrials.gov], identifier [NCT02917980].

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement in patients with quadricuspid aortic valve in a single center

Liu

Zhai

et al. 2022

Front. Cardiovasc. Med.

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“…1 Various QAV subtypes with unequal-sized cusps and subsequent coaptation failure with progressive cusp fibrosis would be key mechanisms in severe AR. 2 , 3 …”

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confidence: 99%