Concomitant Transcatheter Aortic and Mitral Valve Replacement

Q4 Medicine

JACC. Case reports Pub Date : 2025-06-25 DOI:10.1016/j.jaccas.2025.103772

Julio Echarte-Morales MD , Berenice Caneiro-Queija MD, PhD , Manuel Barreiro-Pérez MD, PhD , Francisco Estévez-Cid MD , Rocío González-Ferreiro MD, PhD , Miguel Piñón-Esteban MD , José Antonio Baz-Alonso MD , Rodrigo Estévez-Loureiro MD, PhD , Andrés Iñiguez-Romo MD, PhD

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Abstract

Background

Multivalvular heart disease is a highly prevalent condition that causes significant morbidity and mortality.

Case Summary

A 75-year-old man presented with worsening functional class and asthenia. A transthoracic echocardiogram showed severe aortic stenosis and severe mitral stenosis. The patient underwent transcatheter aortic and mitral valve replacement in the same procedure.

Discussion

There is a lack of solid evidence regarding the management of multivalvular disease. Severe mitral stenosis can influence aortic stenosis, potentially leading to a low-flow, low-gradient profile. Establishing a streamlined workflow between transesophageal echo and cardiac tomography optimizes procedural safety, efficiency, and outcomes in patients with concomitant mitral and aortic disease.

Take-Home Messages

This case highlights the relevance of multimodality imaging for procedural planning in complex multivalvular disease. Concomitant transcatheter implantation of transcatheter aortic valve replacement for aortic stenosis followed by a transcatheter mitral valve replacement in mitral stenosis is a feasible option for patients at high surgical risk.

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合并经导管主动脉瓣和二尖瓣置换术。

背景：多瓣心脏病是一种非常普遍的疾病，发病率和死亡率都很高。病例总结：一名75岁男性，表现为功能等级恶化和虚弱。经胸超声心动图显示严重主动脉瓣狭窄和二尖瓣狭窄。患者在同一手术中接受了经导管主动脉瓣和二尖瓣置换术。讨论：关于多瓣膜疾病的治疗缺乏可靠的证据。严重的二尖瓣狭窄会影响主动脉瓣狭窄，可能导致低血流、低梯度。在经食管超声和心脏断层扫描之间建立简化的工作流程，可优化合并二尖瓣和主动脉疾病患者的手术安全性、效率和预后。关键信息：本病例强调了多模态成像与复杂多瓣膜疾病手术计划的相关性。主动脉瓣狭窄患者同时行经导管主动脉瓣置换术，二尖瓣狭窄患者同时行经导管二尖瓣置换术，对于手术风险高的患者是一种可行的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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