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Plaster pipes and crystalized graphite: Open transventricular transcatheter aortic valve replacement for failed mechanical aortic valve prostheses in the porcelain aorta
Author(s) -
Yong Matthew S.,
Camuglia Anthony C.,
Cox Stephen V.,
Cole Christopher M.
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29465
Subject(s) - medicine , mechanical valve , aorta , aortic valve , cardiology , prosthesis , cardiopulmonary bypass , surgery
Patients with a true porcelain aorta and a failed mechanical aortic valve prosthesis have limited treatment options. Using a hybrid of an open trans‐ventricular approach with peripheral cardiopulmonary bypass and integration of transcatheter techniques this challenge can be overcome. Trans‐ventricular mechanical valve extraction (with transcatheter endovascular occlusion and cardioplegia) followed by direct ante‐grade transcatheter heart valve implantation offers a potential solution to this conundrum. The procedure described is a novel technique that allows for the effective treatment of patients with failed mechanical surgical aortic valve prostheses in the setting of an inoperable porcelain aorta. In addition, a collaborative integrated multi‐disciplinary heart team environment is required for the management of these complex patients.