title: Transcatheter ACURATE-TA Aortic Valve Implantation in a Patient With a Previous Mechanical Mitral Valve.
abstract: Transcatheter aortic valve implantation (TAVI) in the presence of a mechanical mitral valve (MMV) prosthesis is still challenging because of the rigid mitral frame within the aortomitral curtain. Moreover, low-lying coronary ostia represent a hazardous problem of coronary obstruction, especially in narrow or porcelain aortic roots. The present case demonstrates the successful management of 2 challenging anatomical issues, the rigid cage of the MMV and the low-lying left main coronary ostium (LMCO), with the implantation of the ACURATE-TA bioprosthesis (Symetis SA, Ecublens, Switzerland). It also highlights the importance of having multiple TAVI devices in order to choose the ideal transcatheter aortic bioprosthesis to fit the unique anatomical presentation of the patient.
authors.affiliation: Division of Cardiology, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada. Electronic address: rodrigo.bagur@lhsc.on.ca.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Bagur
authors.affiliation: Division of Cardiac Surgery, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Bob
authors.initials: B
authors.lastname: Kiaii
authors.affiliation: Division of Cardiology, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Teefy
authors.affiliation: Division of Cardiology, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Diamantouros
authors.affiliation: Division of Cardiac Anesthesia, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Harle
authors.affiliation: Division of Radiology, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Aashish
authors.initials: A
authors.lastname: Goela
authors.affiliation: Division of Radiology, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Chan
authors.affiliation: Division of Cardiac Surgery, University Hospital, London Health Science Centre, Western University, London, Ontario, Canada.
authors.forename: Michael W A
authors.initials: MW
authors.lastname: Chu
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*