title: Late surgical explantation and aortic valve replacement after transcatheter aortic valve implantation.
abstract: Transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve disease is associated with higher rates of paravalvular aortic regurgitation, which may require subsequent surgical correction. We report a case of successful late surgical CoreValve explantation 1,389 days after TAVI in a patient with bicuspid aortic valve stenosis and McArdle's disease who developed severe paravalvular aortic regurgitation. We confirm that neoendothelialization and incorporation of the nitinol cage into the aortic wall had occurred at nearly 4 years postimplantation, although explantation with careful endarterectomy could still be performed without requiring simultaneous aortic root replacement.
authors.affiliation: Department of Cardiology, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
authors.forename: Louis W
authors.initials: LW
authors.lastname: Wang
authors.affiliation: St Vincent's Clinical School, University of New South Wales, Sydney, Australia; Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, Australia.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Granger
authors.affiliation: University of Sydney Medical School, Sydney, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: McCourt
authors.affiliation: St Vincent's Clinical School, University of New South Wales, Sydney, Australia; Department of Anesthesia and Intensive Care, St Vincent's Hospital, Sydney, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Pye
authors.affiliation: Macquarie University School of Advanced Medicine, Sydney, Australia.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Kaplan
authors.affiliation: Department of Cardiology, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia. Electronic address: dmuller@stvincents.com.au.
authors.forename: David W M
authors.initials: DW
authors.lastname: Muller
mesh_terms: D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D001705:Bioprosthesis; D020878:Device Removal / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012720:Severity of Illness Index; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome