| Abstract [eng] |
Background: Aortic valve stenosis is the most prevalent valvular disease in developed countries, and the most common valve lesion requiring implantation of prosthetic valve. Pharmacological treatment of this disease is not effective, the standard treatment of severe disease is prosthetic valve implantation. Surgically implanted bioprosthetic valves have longer lifespans than the ones implanted using transcatheter techniques. Young age is one of the most important risk factors for early structural deterioration of bioprosthesis. Due to low complication rates and short hospital stay, transfemoral access is the most common. If transfemoral approach is not suitable, alternative approaches can be considered. Case report: The patient is a 32-year-old female with Marfan syndrome. She had undergone surgical aortic valve replacement in 2016. In 2020 an aortic dissection originating in descending thoracic aorta and extending up to right common iliac artery was diagnosed. A decision was made to perform open surgical repair of the dissection. During presurgical planning, severe aortic stenosis was noted. Another prosthetic valve implantation was needed. Surgical implantation was ruled out because of high surgical risk due to reoperation. It was decided to perform transfemoral valve-in-vale aortic valve implantation. Conclusion: In some extreme cases transfemoral transcatheter aortic valve implantation in patients with aortic dissection it is the most reasonable option. Current case report and case reports found during the literature review prove the feasibility of such procedure. Careful preprocedural examination and the establishment of a safe route from the puncture site to the heart are crucial for the success of the procedure. |
