Sutureless aortic valve replacement and direct Sapien 3 valve-in-valve implantation: a challenging case

摘要

A 72-year-old female was referred to our center for heart failure due to concomitant mitro-aortic biological prosthesis malfunction (severe mitral stenosis with mean gradient 11 mmHg and severe aortic stenosis AVA 0.55 cm ) and severe tricuspid regurgitation. The patient was very frail (body mass index of 19.11 kg/m , Logistic euroSCORE II 22.9%; Society of Thoracic Surgeons score 12.9%), with a history of permanent atrial fibrillation and post-capillary pulmonary hypertension (PAPs/d/m 76/29/46 mmHg) requiring supplemental oxygen. We performed sutureless aortic valve replacement (SU-AVR) with Perceval S (LivaNova, London, United Kingdom), open mitral valve-in-valve procedure with Edwards Sapien 3 (Edwards Lifescience, Irvine, California, USA) and tricuspid valve annuloplasty.