Successful transfemoral core valve aortic valve implantation in a patient with degenerated solofreedom biologic supravalvular aortic valve

Abstract

Percutaneous aortic valve implantation (TAVI) is well established treatment option for high risp patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) is an attractive treatment option for patients with failing bioprostheses (valve-in-valve concept), especially in elderly patients with high risk for reoperation. Although clinical experience is still limited for this off-label indication, the procedure has been shown to be feasible in stented as well as stentless bioprostheses. We report a case of of 71-years old woman were CoreValve 23 mm (Medtronic, Inc., Minneapolis, Minnesota, USA) was implanted inside a degenerated Sorin Freedom SOLO bioprosthesis using transfemoral approach. Freedom SOLO bioprosthesis stentless bioprosthesis is sutured in supra-annular position and presents a TAVI challenge due to its proximity to coronary ostia. Careful pre-procedural planning with TEE and CTA is crucial. We decided for transfemoral approach with 23 m CoreValve implantation. Balloon valvuloplasty before TAVI with contrast injection may predict the final result and is helpful for procedure success and risk reduction. The final TAVR result was good. This case proves the ViV concept for stentless Freedom SOLO bioprosthesis.