Long-term management of aortic stenosis (surgery and transcatheter options in young patients): a case report of valve-in-valve transcatheter aortic valve implantation

Recent evidences have supported the use of transcatheter aortic valve implantation (TAVI) across all risk categories of patients. However, in case of young patients several points should be considered in a lifetime perspective taking into account both surgical and percutaneous therapies.

An 82-year-old man with a history of aortic valve disease treated 12 years earlier with surgical aortic valve and aortic root replacement was admitted for worsening dyspnoea. Echocardiogram showed degenerated surgical bioprosthesis with severe regurgitation. Due to prior surgery and high operative risk, the heart team opted for valve-in-valve TAVI. The procedure was successful and the patient remained asymptomatic at 30-day follow-up.

This case shows how to approach aortic valve disease in a lifetime perspective. Surgical and percutaneous approaches can be used in multiple combinations according to patient’s age, anatomical characteristics and personal preferences.