Transcatheter aortic valve implantation in patient with combined aortic and subaortic membrane stenosis: a case report

经导管主动脉瓣置换术治疗合并主动脉瓣和主动脉下膜狭窄患者:病例报告

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Abstract

BACKGROUND: The combination of symptomatic aortic stenosis (AS) and subaortic membrane (SAM) is rare, and the haemodynamic consequences of this combination are challenging to diagnose and manage. CASE SUMMARY: We present the case of a 78-year-old male who presented with symptomatic AS and chronic heart failure. On echocardiography, the combination of AS and SAM was diagnosed. Transoesophageal echocardiography (TOE) was performed to confirm the presence and severity of AS and SAM. Based on the patient's clinical profile and the high risk of surgical repair, a self-expandable transcatheter aortic valve implantation (TAVI) was performed. Three-month follow-up was uneventful. In addition, we discuss the assessment and management strategy challenges for SAM in patients with aortic regurgitation or AS. DISCUSSION: As transcatheter valve implantation expands its indications for more complex anatomy and patient's comorbidity. Self-expandable TAVI-prosthesis under TOE guidance is feasible for the treatment of symptomatic AS and SAM, especially in patients with high surgical risk.

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