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You are here: Contents > 2015 > Volume 24 Number 2 March 2015 > REPLACEMENT VALVE EVALUATION > Transcatheter Aortic Valve-In-Valve Implantation for Severe Bioprosthetic Stenosis after Bentall Operation Using a Homograft in a Patient with BehÁetís Disease

Transcatheter Aortic Valve-In-Valve Implantation for Severe Bioprosthetic Stenosis after Bentall Operation Using a Homograft in a Patient with BehÁetís Disease

Hyung Joon Joo, Soon Jun Hong, Cheol Woong Yu

Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea

A 43-year-old man presented with severe aortic stenosis. Eight years previously, he had undergone primary surgical aortic valve replacement (AVR) for severe aortic regurgitation, but one year later developed cardiac arrest and complete atrioventricular block as a result of non-bacterial thrombotic endocarditis with severe valvular dehiscence. Following the diagnosis of prosthetic valve failure caused by Behçet’s disease, the patient underwent a Bentall operation using 23 mm aortic homograft with permanent pacemaker implantation and coronary artery bypass grafting. Subsequently, he was stable with steroid administration and azathioprine for seven years after the second operation, but recently suffered from severe dyspnea and chest pain. Echocardiography revealed the development of severe aortic stenosis. A pre-procedural evaluation demonstrated a porcelain aorta with severe calcification in the previous homograft valve on


computed tomography, and critical stenosis at the ostium of the left circumflex artery on coronary angiography. After percutaneous coronary intervention for the ostium of the left circumflex artery, a transcatheter AVR was successfully performed using a 26 mm Edwards SAPIEN XT valve. The patient recovered without any complications after the procedure. This is the first report of a successful transcatheter aortic valve-in-valve implantation for severe homograft aortic stenosis after a Bentall operation, using a homograft, in a patient with Behçet’s disease.

Video 1: Transesophageal echocardiography after additional inflation (long-axis). [click to view]

Video 2: Transesophageal echocardiography after additional inflation (short-axis). [click to view]

The Journal of Heart Valve Disease 2015;24:217-219


Transcatheter Aortic Valve-In-Valve Implantation for Severe Bioprosthetic Stenosis after Bentall Operation Using a Homograft in a Patient with Behçet’s Disease

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