Redo in aortic homograft replacement: Transcatheter aortic valve as a valid alternative to surgical replacement

Abstract

CLINICAL SUMMARY A 48-year-old woman was referred to our hospital with symptoms of ingravescent severe dyspnea. Fifteen years earlier, she had undergone placement of a 21-mm aortic valve Bravo 400 stentless xenograft (Cryolife International, Atlanta, Ga). Four years later, she underwent a valve replacement with a 21-mm mechanical prosthesis (Carbomedics, Austin, Tex) for valve degeneration, and subsequently, she received a homograft for aortic valve endocarditis. The echocardiographic control, performed during the last 15 years, showed progressive calcific valve degeneration with a peak transvascular pressure gradient of 41 mm Hg and aortic valve area of 0.5 cm. Preoperative computed tomographic angiographic analysis showed diffuse aortic root