Successful transfemoral core valve aoric valve implantaion in a paient with degenerated solofreedom biologic supravalvular aoric valve

Matjaž Bunc1,4, Polonca Kogoj1, Jana Ambrožič1, Špela Mušič2, Nikola Lakič2, Borut Geršak2
1Department of Cardiology, University Medical Centre Ljubljana, Zaloška c. 007, 1000 Ljubljana, 2Department for Cardio and Vascular Surgery, University Medical Centre Ljubljana, 3Department of Radiology, University Medical Centre Ljubljana, Zaloška c. 007, 1000 Ljubljana, 4 Insitute for Pathopysilogy, School of Medicine, Zaloška c.002, 1000 Ljubljana

Percutaneous aoric valve implantaion (TAVI) is well established treatment opion for high risp paients with severe aoric stenosis. Transcatheter aoric valve implantaion (TAVI) is an atracive treatment opion for paients with failing bioprostheses (valve-in-valve concept), especially in elderly paients with high risk for reoperaion. Although clinical experience is sill limited for this of-label indicaion, the procedure has been shown to be feasible in stented as well as stentless bioprostheses. We report a case of of 71-years old woman were CoreValve 23 mm (Medtronic, Inc., Minneapolis, Minnesota, USA) was implanted inside a degenerated Sorin Freedom SOLO bioprosthesis using transfemoral approach. Freedom SOLO bioprosthesis stentless bioprosthesis is sutured in supra-annular posiion and presents a TAVI challenge due to its proximity to coronary osia. Careful pre-procedural planning with TEE and CTA is crucial. We decided for transfemoral approach with 23 m CoreValve implantaion. Balloon valvuloplasty before TAVI with contrast injecion may predict the inal result and is helpful for procedure success and risk reducion. The inal TAVR result was good. This case proves the ViV concept for stentless Freedom SOLO bioprosthesis.

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