Cor Vasa 2018, 60(5):e540-e546 | DOI: 10.1016/j.crvasa.2017.06.015

Transcatheter aortic valve replacement - Therapeutical option in a patient with complex heart disease

Petr Zdráhal^a,b,*, Josef Bis^a, Pavel Polanský^c, Jaroslav Dušek^a, Josef Šťásek^a

^a I. interní kardioangiologická klinika, Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

^b Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Hradec Králové, Česká republika

^c Kardiochirurgická klinika, Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

Authors are presenting a case report describing diagnostic and therapeutic approach in a patient with severe dyspnea. Dominant cause of the symptoms was combined aortic disorder and monstrous obesity. The other findings were combined mitral valve disorder and provoked midventricular obstruction of left ventricle. Complex cardiac surgery was not recommended due to aortic valve anulus size, massive calcification of both mitral and aortic valves and extreme obesity resulting in high risk of perioperative mortality. As alternative approach, transcatheter aortic valve replacement procedure (TAVR) was performed. In a very difficult terrain we finally reached maximum possible result - considerable decrease of dyspnoea and reduction of midventricular obstruction. This case reports additional application for transcatheter stent bioprothesis in patients with complex cardiac disease.

Keywords: Aortic valve stenosis; Calcification; Dyspnoea; Midventricular obstruction; Obesity; TAVR

Received: March 21, 2017; Accepted: June 29, 2017; Published: October 1, 2018  Show citation