A Case of TAV-in-SAV in a Patient with Structural Valve Deterioration after Surgical Aortic Valve Replacement with the INSPIRIS RESILIA Valve.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2024-01-25 Epub Date: 2022-08-23 DOI:10.5761/atcs.cr.22-00083

Masaru Matsuda, Koichi Maeda, Kazuo Shimamura, Kizuku Yamashita, Ai Kawamura, Daisuke Yoshioka, Shigeru Miyagawa

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Abstract

The INSPIRIS RESILIA valve is designed to dilate its valve annulus in transcatheter aortic valve-in-surgical aortic valve (TAV-in-SAV), a catheter therapy for biological valve deterioration. RESILIA tissue has improved anti-calcification properties. An 83-year-old man on hemodialysis undergoing surgical aortic valve replacement (SAVR) with a 25-mm INSPIRIS for severe aortic stenosis 22 months ago presented with general malaise. Transthoracic echocardiography revealed severe bioprosthetic stenosis (peak velocity: 3.5 m/s, mean pressure gradient: 32 mmHg, and effective orifice area: 0.45 cm²) and severely reduced left ventricular function (ejection fraction: 17%). Because redo-SAVR was extremely risky (society of thoracic surgeons [STS] risk score: 31%), the patient underwent transfemoral-TAV-in-SAV using a 26-mm SAPIEN 3️. Pre- and postoperative computed tomography showed that the internal diameter of the INSPIRIS had expanded from 22.2 mm to 24.2 mm. This case demonstrated the dilatable design of INSPIRIS but not the durability of RESILIA tissue.

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INSPIRIS RESILIA瓣膜手术主动脉瓣置换术后结构性瓣膜恶化患者的TAV-in-SAV病例。

INSPIRIS RESILIA瓣膜的设计目的是在经导管主动脉瓣置入手术主动脉瓣（TAV-in-SAV）中扩张瓣环，这是一种针对生物瓣膜退化的导管疗法。RESILIA 组织具有更好的抗钙化特性。22 个月前，一名 83 岁的男子因严重主动脉瓣狭窄接受了 25 毫米 INSPIRIS 手术主动脉瓣置换术（SAVR），当时他全身不适，正在进行血液透析。经胸超声心动图显示他的主动脉瓣有严重的生物假体狭窄（峰值速度：3.5 m/s，平均压力梯度：32 mmHg，有效瓣口面积：0.45 cm2）：左心室功能严重减退（射血分数：17%）。由于重做 SAVR 风险极高（胸外科医师协会 [STS] 风险评分：31%），患者接受了经股动脉 TAV-in-SAV 手术，使用的是 26 毫米 SAPIEN 3️。术前和术后的计算机断层扫描显示，INSPIRIS的内径从22.2毫米扩大到24.2毫米。该病例证明了INSPIRIS的可扩张设计，但并不证明RESILIA组织的耐用性。

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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