Cargando…

A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient

This case presentation involves an 80-year-old male with a history of surgically repaired patent ductus arteriosus and surgical aortic valve replacement due to infective endocarditis, who presented with progressive heart failure symptoms and was found to have a severe aortic paravalvular leak (PVL)...

Descripción completa

Detalles Bibliográficos
Autores principales: Rahman, Saad Ur, Prasad, Krishna, Akram, Muhammad Shariq, Adoni, Naveed, Mehta, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439814/
https://www.ncbi.nlm.nih.gov/pubmed/37600434
http://dx.doi.org/10.7759/cureus.43765
_version_ 1785093033893560320
author Rahman, Saad Ur
Prasad, Krishna
Akram, Muhammad Shariq
Adoni, Naveed
Mehta, Sanjay
author_facet Rahman, Saad Ur
Prasad, Krishna
Akram, Muhammad Shariq
Adoni, Naveed
Mehta, Sanjay
author_sort Rahman, Saad Ur
collection PubMed
description This case presentation involves an 80-year-old male with a history of surgically repaired patent ductus arteriosus and surgical aortic valve replacement due to infective endocarditis, who presented with progressive heart failure symptoms and was found to have a severe aortic paravalvular leak (PVL) and ascending thoracic aortic aneurysm. Due to complex surgical anatomy and multiple chronic comorbidities, he was considered a poor candidate for traditional valve replacement surgery including the Bentall procedure. Instead, a multidisciplinary team opted for transcatheter paravalvular leak closure (TPLC) with an Amplatzer plug followed by planned endovascular aortic aneurysm repair. The patient showed significant improvement in symptoms and reduction in aneurysm size post-procedure leading to avoidance of the open-heart surgery. This case highlights the effectiveness of the percutaneous approach in high-risk surgical patients with PVL and complex anatomical considerations.
format Online
Article
Text
id pubmed-10439814
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-104398142023-08-20 A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient Rahman, Saad Ur Prasad, Krishna Akram, Muhammad Shariq Adoni, Naveed Mehta, Sanjay Cureus Cardiac/Thoracic/Vascular Surgery This case presentation involves an 80-year-old male with a history of surgically repaired patent ductus arteriosus and surgical aortic valve replacement due to infective endocarditis, who presented with progressive heart failure symptoms and was found to have a severe aortic paravalvular leak (PVL) and ascending thoracic aortic aneurysm. Due to complex surgical anatomy and multiple chronic comorbidities, he was considered a poor candidate for traditional valve replacement surgery including the Bentall procedure. Instead, a multidisciplinary team opted for transcatheter paravalvular leak closure (TPLC) with an Amplatzer plug followed by planned endovascular aortic aneurysm repair. The patient showed significant improvement in symptoms and reduction in aneurysm size post-procedure leading to avoidance of the open-heart surgery. This case highlights the effectiveness of the percutaneous approach in high-risk surgical patients with PVL and complex anatomical considerations. Cureus 2023-08-19 /pmc/articles/PMC10439814/ /pubmed/37600434 http://dx.doi.org/10.7759/cureus.43765 Text en Copyright © 2023, Rahman et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Rahman, Saad Ur
Prasad, Krishna
Akram, Muhammad Shariq
Adoni, Naveed
Mehta, Sanjay
A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title_full A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title_fullStr A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title_full_unstemmed A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title_short A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient
title_sort treatment dilemma: bentall vs transcatheter paravalvular leak closure with aortic aneurysm repair in a high surgical risk patient
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439814/
https://www.ncbi.nlm.nih.gov/pubmed/37600434
http://dx.doi.org/10.7759/cureus.43765
work_keys_str_mv AT rahmansaadur atreatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT prasadkrishna atreatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT akrammuhammadshariq atreatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT adoninaveed atreatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT mehtasanjay atreatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT rahmansaadur treatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT prasadkrishna treatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT akrammuhammadshariq treatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT adoninaveed treatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient
AT mehtasanjay treatmentdilemmabentallvstranscatheterparavalvularleakclosurewithaorticaneurysmrepairinahighsurgicalriskpatient