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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 |
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| Authors: | Matthew S. Yong MBBS Anthony C. Camuglia MBBS MHA FRACP FCSANZ Stephen V. Cox MBBS FRACP FCSANZ Christopher M. Cole BA MBBS FRACS |
| Affiliation: | 1. Department of Cardiothoracic Surgery, Princess Alexandra Hospital, Ipswich Road, Brisbane, Australia University of Queensland, Brisbane, Australia;2. University of Queensland, Brisbane, Australia;3. University of Queensland, Brisbane, Australia Department of Cardiology, Princess Alexandra Hospital, Ipswich Road, Brisbane, Australia;4. Department of Cardiothoracic Surgery, Princess Alexandra Hospital, Ipswich Road, Brisbane, Australia |
| Abstract: | 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. |
| Keywords: | failed mechanical valve prosthesis porcelain aorta transcatheter aortic valve implantation transcatheter aortic valve replacement transventricular TAVI transventricular TAVR |