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Interventions for structural heart disease

CoreValve Evolut R implantation as valve-in-valve in an Edwards SAPIEN 3 to treat paravalvular regurgitation

EuroIntervention 2015;11:e1 published online e-article September 2015. DOI: 10.4244/EIJV11I5A116

1. Cardiology & Cardiac Surgery Department, Niguarda Ca’ Granda Hospital, Milan, Italy; 2. Cardiothoracic Anesthesia and Intensive Care, Niguarda Ca’ Granda Hospital, Milan, Italy
A 75-year-old male underwent transfemoral transcatheter aortic valve implantation (TAVI) with a 23 mm SAPIEN 3 (Edwards Lifesciences Inc., Irvine, CA, USA). One year after, he was admitted to our department for pulmonary oedema. Echocardiographic evaluation evidenced low placement of the SAPIEN 3 and 3-(4)+/4+ aortic regurgitation. ECG-gated multislice computed tomography (MSCT) was performed which confirmed low placement (Moving image 1) and underexpansion of the SAPIEN 3 with a perimeter of 62 mm and diameter of 20 mm (Figure 1A-Figure 1C). After Heart Team evaluation, a new TAVI procedure was preferred with the implantation of a 26 mm CoreValve® Evolut R™ (Medtronic, Minneapolis, MN, USA). Basal aortography evidenced ...

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