Abstract
We report a patient with severe aortic stenosis with an extremely high calcium score
who underwent a transfemoral transcatheter aortic valve replacement with an Evolut
R (Medtronic, Minneapolis, MN) and needed a valve-in-valve approach with a SAPIEN
3 (Edwards Lifesciences, Irvine, CA) to treat significant paravalvular leak. Interestingly,
the closure time with adenosine diphosphate, assessed using the Platelet Function
Analyzer 100 (Siemens Healthcare Diagnostics, Los Angeles, CA), measured after each
important step of this complex procedure, correlated very well with the severity of
the paravalvular leak.
Résumé
Nous rapportons le cas d’un patient présentant une sténose aortique grave et un taux
extrêmement élevé de calcium, qui a subi un remplacement valvulaire aortique par cathéter
par voie transfémorale au moyen du système Evolut R (Medtronic, Minneapolis, Minnesota)
et qui a nécessité l’installation d’une valve SAPIEN 3 (Edwards Lifesciences, Irvine,
Californie) dans la valve déjà en place pour traiter une importante fuite paravalvulaire.
Fait intéressant, une étroite corrélation a été observée entre la gravité de la fuite
paravalvulaire et le temps de fermeture avec l’adénosine-diphosphate, évaluée à l’aide
du dispositif Platelet Function Analyzer 100 (Siemens Healthcare Diagnostics, Los
Angeles, Californie) et mesurée après chaque étape importante de cette intervention
complexe.
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References
- Von Willebrand factor multimers during transcatheter aortic-valve replacement.N Engl J Med. 2016; 375: 335-344
- Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study.J Am Coll Cardiol. 2014; 64: 1202-1213
- Transcatheter aortic valve implantation in 2017: state of the art.EuroIntervention. 2017; 13: AA11-AA21
Article info
Publication history
Published online: May 30, 2019
Accepted:
May 17,
2019
Received:
February 10,
2019
Footnotes
See page 1419.e20 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
