[Redo Surgical Aortic Valve Replacement for Dysfunctional Transcatheter Aortic Valve Implanted for Degenerated Surgical Bioprosthesis].

Abstract

An 81-year-old man underwent surgical aortic valve replacement (SAVR) for stenotic bicuspid valve with a 21-mm CEP bioprosthesis 17 years ago. Four years ago, he underwent valve-in-valve (ViV)transcatheter aortic valve replacement (TAVR) using a self-expandable Evolut R 23-mm valve due to structural valve deterioration (SVD) and redo SAVR was indicated because of repeat SVD and heart failure symptoms. Transcatheter valve and prior surgical valve adhered to the anterior mitral leaflet. Removal of the valve caused perforation, which required repair. Aortic valve replacement was performed using an Epic Plus 21-mm valve. SAVR after TAVR is more invasive and has higher mortality than ViV, but in younger or low-risk patients, treatment should be planned with long-term prognosis in mind.