Transcatheter aortic valve implantation in patient with combined aortic and subaortic membrane stenosis: a case report

European Heart Journal - Case Reports

22 November 2024
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ESC Journals Interventional Cardiology VALVULAR, MYOCARDIAL, PERICARDIAL, PULMONARY, CONGENITAL HEART DISEASE Valvular Heart Disease

Abstract

AbstractBackground

The combination of symptomatic aortic stenosis (AS) and subaortic membrane (SAM) is rare, and the haemodynamic consequences of this combination are challenging to diagnose and manage.

Case summary

We present the case of a 78-year-old male who presented with symptomatic AS and chronic heart failure. On echocardiography, the combination of AS and SAM was diagnosed. Transoesophageal echocardiography (TOE) was performed to confirm the presence and severity of AS and SAM. Based on the patient’s clinical profile and the high risk of surgical repair, a self-expandable transcatheter aortic valve implantation (TAVI) was performed. Three-month follow-up was uneventful. In addition, we discuss the assessment and management strategy challenges for SAM in patients with aortic regurgitation or AS.

Discussion

As transcatheter valve implantation expands its indications for more complex anatomy and patient’s comorbidity. Self-expandable TAVI-prosthesis under TOE guidance is feasible for the treatment of symptomatic AS and SAM, especially in patients with high surgical risk.

Contributors

Abdelrahman Elhakim
Abdelrahman Elhakim

Author

Klinikum Braunschweig Braunschweig , Germany

Mohammed Saad
Mohammed Saad

Author

Sana Klinikum Coburg Coburg , Germany