Page 24 - Journal of Structural Heart Disease Volume 3, Issue 6

Case Report
Journal of Structural Heart Disease, December 2017, Volume 3, Issue 6:180-186
DOI: https://doi.org/10.12945/j.jshd.2017.026.17
Successful First-in-Man Concomitant
Received: June 06, 2017 Accepted: June 15, 2017 Published online: December 2017
Transapical Transcatheter Aortic and Mitral
Valve Replacements for Severe Native Aortic
and Mitral Valve Stenosis Using the Edwards
Certitude Delivery System
Anwar Tandar, MD1, Jason P. Glotzbach, MD2, Frederick G.P. Welt, MD1, Vikas Sharma, MD2, Kelsee Browning, AGNP-C1, Craig H. Selzman, MD2, Abdulfattah Saidi, MD1*, David A. Bull, MD2
1 Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States 2 Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
Abstract
Transcatheter aortic valve replacement (TAVR) has be- come the treatment of choice for high or intermediate risk patients with symptomatic severe aortic stenosis. Transcatheter mitral valve replacement (TMVR) for na- tive mitral stenosis is still under investigation in clini- cal trials. Results from a global registry, however, show that TMVR in patients with severe mitral annulus cal- ci cation is feasible but associated with signi cant ad- verse events. Simultaneous TAVR and TMVR on native valves has only been reported twice. Here, we report the rst case of simultaneous TAVR and TMVR for na- tive aortic and mitral stenosis using the Edwards Certi- tude transapical delivery system.
Copyright © 2017 Science International Corp.
Key Words
Native aortic stenosis • Native mitral stenosis • Simultaneous • Double valve • Transcatheter valve replacement • Transapical approach
Introduction
Transcatheter aortic valve replacement (TAVR)
has emerged as the treatment of choice for patients with severe aortic stenosis who are deemed to be at high or intermediate risk for surgery [1, 2]. Transcath- eter mitral valve replacement (TMVR) for inoperable severe calci c native mitral stenosis is currently un- der investigation in clinical trials [3]. Results from a global registry show that TMVR, when performed in highly selected patients, results in signi cant adverse events [4]. Simultaneous TAVR and TMVR of stenotic native valves has only been reported in two cases [5, 6]. Here, we report the rst case of simultaneous TAVR and TMVR for severely stenotic native aortic and mitral valves in a high-risk patient using the Edwards Certitude transapical delivery system (Edwards Life- sciences, Irvine, CA, USA) (Figure 1).
Case Presentation
The patient was a 71-year-old man with symptom- atic severe aortic stenosis (mean gradient, 53 mmHg; aortic valve area, 0.7 cm2; maximum aortic valve velocity, 4.1 m/s; Figure 2 and Figure 3) and heavily calci ed severe mitral stenosis (mean gradient, 12 mmHg; mitral valve area, 1 cm2; Figure 4 and Figure
* Corresponding Author:
Abdulfattah Saidi, MD
Division of Cardiovascular Medicine
University of Utah School of Medicine
50 North Medical Drive, Salt Lake City, UT 84132, USA
Tel. +1 801 647 2390; Fax: +1 801 585 3362; E-Mail: abdulfattah.saidi@hsc.utah.edu
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2017 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
Accessible online at:
http://structuralheartdisease.org/