RESUMO
AIMS: Mitral valve reoperations due to failing bioprostheses, in patients affected by multiple comorbidities, are associated with high morbidity and mortality. Transcatheter techniques may evolve as complementary approaches to surgery in these patients at high risk for surgery. METHODS AND RESULTS: We describe a case of Direct Flow 25 mm transcatheter valve implantation as valve-in-valve in a degenerated mitral bioprosthesis through a transapical approach in a 63-year-old man affected by dilated cardiomyopathy. The patient was affected by Carpentier-Edwards 29 mm severe regurgitation. The 25 mm Direct Flow bioprosthesis was advanced through the mitral bioprosthesis into the left atrium and then positioned using the three independent positioning wires. Transoesophageal echocardiography evidenced normal Direct Flow function with no paravalvular regurgitation and a low transmitral gradient of 4 mmHg. CONCLUSIONS: Our successful experience, characterised by a Heart Team approach and multidisciplinary patient care, demonstrated the technical feasibility and procedural safety of Direct Flow valve-in-valve mitral implantation.
Assuntos
Bioprótese , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Cateterismo Cardíaco/métodos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico , Reoperação/métodos , Resultado do TratamentoAssuntos
Estenose da Valva Aórtica/cirurgia , Toracotomia , Substituição da Valva Aórtica Transcateter/instrumentação , Substituição da Valva Aórtica Transcateter/métodos , Idoso , Valva Aórtica/cirurgia , Bioprótese , Ponte de Artéria Coronária , Fluoroscopia , Humanos , Masculino , Artéria Torácica Interna/transplante , Grau de Desobstrução VascularRESUMO
We report a case of anterior left ventricular pseudoaneurysm and associated interventricular septal defect, following myocardial infarction. This report shows an unusual clinical presentation, successful echocardiographic management and surgical findings. Echocardiography appeared to be a useful technique, safe and specific for the diagnosis of a rare complication of myocardial infarction. Early recognition of this rare complication has therapeutic importance because immediate surgical correction is life saving.
