Transcatheter aortic valve implantation with a novel pre-packaged self-expandable dry-tissue transcatheter aortic valve: a case report

John Jose; Paul V George; Krishnaprasath V; Raj Sahajanandan

doi:10.1093/ehjcr/ytaa539

Transcatheter aortic valve implantation with a novel pre-packaged self-expandable dry-tissue transcatheter aortic valve: a case report

Eur Heart J Case Rep. 2020 Dec 28;5(2):ytaa539. doi: 10.1093/ehjcr/ytaa539. eCollection 2021 Feb.

Authors

John Jose¹, Paul V George¹, Krishnaprasath V¹, Raj Sahajanandan²

Affiliations

¹ Department of Cardiology, Cardiac valve and structural heart disease clinic, Cardiology unit-2, Christian Medical College Hospital Vellore, Ida, Scudder Road, Vellore 620004, Tamil Nadu, India.
² Department of Anaesthesia, Christian Medical College Hospital Vellore, Ida, Scudder Road, Vellore 620004, Tamil Nadu, India.

Abstract

Background: Current commercially available transcatheter aortic valves are stored separately in a glutaraldehyde solution and mounted onto the delivery system by a technical expert during the transcatheter aortic valve implantation (TAVI) procedure. A pre-mounted dry-tissue valve that is crimped on a ready-to-use delivery system could simplify the procedure. The Vienna self-expanding transcatheter valve (P&F, GmbH, Wessling, Germany) is a novel ready-to-use pre-mounted dry-tissue transcatheter aortic valve. There are no prior reports on the efficacy of this valve system.

Case summary: Here, we report our experience of an implantation of a novel ready-to-use dry-tissue Vienna transcatheter aortic valve in a 72-year-old male with symptomatic severe aortic stenosis and severe left ventricular systolic dysfunction. He had presented with heart failure [N-terminal pro-brain natriuretic peptide (NT-proBNP) level at the admission of 10 600 pg/mL], New York Heart Association Class-3, and recurrent syncope. A 26 mm Vienna valve was successfully implanted via the transfemoral route under conscious sedation. There were no complications. The patient was discharged in a stable condition on the third post-procedure day. At 1-year follow-up, the valve is functioning well with no evidence of structural degeneration (mean gradient 9 mmHg, no valvular regurgitation). Currently, he is asymptomatic with normal left ventricular systolic function on echocardiography (NT-proBNP 57 pg/mL).

Discussion: To our knowledge, this is the first case of TAVI performed with the dry-tissue pre-mounted VIENNA valve. Our case highlights the feasibility and short-term efficacy of the VIENNA valve. Further safety and durability need to be addressed by a multicentre trial.

Keywords: Aortic stenosis; Case report; Dry-tissue transcatheter aortic valve; Self-expanding valve; Transcatheter aortic valve implantation; Vienna valve.