Implantation of the CoreValve percutaneous aortic valve.
Surgical aortic valve replacement is the only recommended treatment for significant aortic valve stenosis. Percutaneous aortic valve replacement appears to be a novel option for high-risk patients. We report the implantation of the ReValving system (CoreValve, Paris, France) in a 64-year-old woman who was refused aortic valve replacement surgery for critical aortic stenosis and left ventricular dysfunction because of severe pulmonary fibrosis. After anesthesia, the patient was put on femorofemoral cardiopulmonary bypass, and underwent a balloon valvuloplasty with subsequent retrograde aortic valve replacement by the ReValving system. Transesophageal echocardiographic monitoring of the patient's hemodynamics showed immediate improvements of the valvular area and left ventricular ejection fraction and only traces of paravalvular leaks. The patient was easily weaned from ventilation and resumed activity soon after the surgery. A multidisciplinary approach is presently necessary to offer a reliable and safe procedure.
Lamarche
Yoan
Y
Department of Surgery, Montréal Heart Institute and Université de Montréal, Montréal, Québec, Canada.
Cartier
Raymond
R
Denault
André Y
AY
Basmadjian
Arsène
A
Berry
Colin
C
Laborde
Jean-Claude
JC
Bonan
Raoul
R
D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged