Abstract

ZAMORA-RODRIGUEZ, Carlos A; LEON-BURGOS, A. Luis; YUCRA-LAZO, Jorge  and  RAMIREZ-ZAPATA, Juan Carlos. Transapical transcatheter aortic valve replacement: a new procedure in Northern Peru. Acta méd. Peru [online]. 2018, vol.35, n.1, pp.60-64. ISSN 1728-5917.

Severe symptomatic aortic stenosis secondary to degenerative calcification may be a real therapeutic challenge if the patient does not undergo an aortic valve replacement. Transapical transcatheter aortic valve replacement is a valid therapeutic option for these cases. We present the case of a 78-year old male with the following past and current medical history: high blood pressure, chronic kidney disease (stage IIIa), heavy tobacco smoking, use of a permanent pacemaker, peripheral arterial disease, and polycythemia vera. When assessed, the patient had had class III heart failure (NYHA classification) for one year. Transthoracic ultrasonography showed severe calcification of the aortic cusps, a 44.7% left ventricular ejection fraction, and a 0.58 cm2 (0.31 cm2/m2) valve surface area. Angiography showed moderate coronary heart disease, and angiotomography showed severe calcification of the aortic valve (‘porcelain aorta’). Since this patient was considered at high-risk, a transapical transcatheter aortic valve replacement was performed (Braille Biomedical N° 30 bioprosthetic valve), and the ultrasonography controls showed satisfactory results. This case is the first procedure of its kind performed in Northern Peru

Keywords : Aortic valve stenosis; Transcatheter aortic valve replacement; Heart valve prosthesis implantation.

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