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This chapter presents a complex case of an 83-year-old woman with a previous history of aortic valve replacement who was admitted to the Emergency Department with acute pulmonary edema due to acute massive aortic regurgitation secondary to bioprosthesis dysfunction, necessitating urgent intervention. Through a comprehensive diagnostic work-up and multidisciplinary heart team collaboration, the patient was identified as a candidate for emergency transcatheter aortic valve replacement (TAVR). This chapter delves into the complexities of procedural planning, considering factors such as appropriate device selection for valve-in-valve TAVR, the risk of coronary artery occlusion, and the potential for cerebral embolization. It highlights the significance of meticulous assessment and tailored interventions in managing acute aortic regurgitation, emphasizing the role of advanced imaging modalities and advanced procedural techniques. Ultimately, the successful execution of the TAVR procedure, accompanied by adjunctive strategies to mitigate procedural risks, resulted in a favorable clinical outcome for the patient. This case underscores the critical importance of timely recognition and intervention in addressing acute aortic regurgitation, while also elucidating evolving paradigms in the management of valvular heart disease.

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Difficult Cases and Complications from the Catheterization Laboratory: Case 1: Acute Massive Aortic Regurgitation Secondary to Prosthetic Cusp Eversion Successfully Treated with Valve-in-Valve TAVR with Double Chimney Stenting

  • 章节

  • 发表日期：

    2026年

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  • Matteo Maurina,
  • Paolo Pagnotta,
  • Antonio Mangieri,
  • Bernhard Reimers,
  • Damiano Regazzoli

摘要

This chapter presents a complex case of an 83-year-old woman with a previous history of aortic valve replacement who was admitted to the Emergency Department with acute pulmonary edema due to acute massive aortic regurgitation secondary to bioprosthesis dysfunction, necessitating urgent intervention. Through a comprehensive diagnostic work-up and multidisciplinary heart team collaboration, the patient was identified as a candidate for emergency transcatheter aortic valve replacement (TAVR). This chapter delves into the complexities of procedural planning, considering factors such as appropriate device selection for valve-in-valve TAVR, the risk of coronary artery occlusion, and the potential for cerebral embolization. It highlights the significance of meticulous assessment and tailored interventions in managing acute aortic regurgitation, emphasizing the role of advanced imaging modalities and advanced procedural techniques. Ultimately, the successful execution of the TAVR procedure, accompanied by adjunctive strategies to mitigate procedural risks, resulted in a favorable clinical outcome for the patient. This case underscores the critical importance of timely recognition and intervention in addressing acute aortic regurgitation, while also elucidating evolving paradigms in the management of valvular heart disease.