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Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report

BACKGROUND: Aortic valve regurgitation leading to coronary steal phenomenon can severely impair cardiac function in hypoplastic left heart syndrome, thus worsening long-term outcome. CASE PRESENTATION: A German infant with borderline aortic and mitral valve, hypoplastic left ventricle, ventricular s...

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Autores principales: Fürniss, Hannah E., Kubicki, Rouven, Stiller, Brigitte, Reineker, Katja, Siepe, Matthias, Grohmann, Jochen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635989/
https://www.ncbi.nlm.nih.gov/pubmed/31311582
http://dx.doi.org/10.1186/s13256-019-2141-5
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author Fürniss, Hannah E.
Kubicki, Rouven
Stiller, Brigitte
Reineker, Katja
Siepe, Matthias
Grohmann, Jochen
author_facet Fürniss, Hannah E.
Kubicki, Rouven
Stiller, Brigitte
Reineker, Katja
Siepe, Matthias
Grohmann, Jochen
author_sort Fürniss, Hannah E.
collection PubMed
description BACKGROUND: Aortic valve regurgitation leading to coronary steal phenomenon can severely impair cardiac function in hypoplastic left heart syndrome, thus worsening long-term outcome. CASE PRESENTATION: A German infant with borderline aortic and mitral valve, hypoplastic left ventricle, ventricular septal defect, and hypoplastic aortic arch with critical coarctation initially underwent aortic arch reconstruction and aortic valve dilation with the aim of biventricular correction later on. Unfortunately, severe cardiac dysfunction necessitated a change in strategy entailing modified stage I Norwood palliation. Increasing aortic regurgitation with coronary steal was revealed postoperatively, which required redo surgery to oversew the valve. However, pronounced aortic regurgitation recurred, causing severe cardiac decompensation with repeated resuscitation. As a bailout strategy, we performed aortic valve closure via transfemoral retrograde implantation of an Amplatzer Duct Occluder II device. This led to the patient’s rapid stabilization while circumventing highly risky renewed surgery in such a critically ill infant. CONCLUSIONS: Retrograde transcatheter aortic valve closure may be considered a feasible alternative in infants with a failing single ventricle due to aortic regurgitation, with critical device evaluation being crucial for successful device implantation in this young age group. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13256-019-2141-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-66359892019-07-25 Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report Fürniss, Hannah E. Kubicki, Rouven Stiller, Brigitte Reineker, Katja Siepe, Matthias Grohmann, Jochen J Med Case Rep Case Report BACKGROUND: Aortic valve regurgitation leading to coronary steal phenomenon can severely impair cardiac function in hypoplastic left heart syndrome, thus worsening long-term outcome. CASE PRESENTATION: A German infant with borderline aortic and mitral valve, hypoplastic left ventricle, ventricular septal defect, and hypoplastic aortic arch with critical coarctation initially underwent aortic arch reconstruction and aortic valve dilation with the aim of biventricular correction later on. Unfortunately, severe cardiac dysfunction necessitated a change in strategy entailing modified stage I Norwood palliation. Increasing aortic regurgitation with coronary steal was revealed postoperatively, which required redo surgery to oversew the valve. However, pronounced aortic regurgitation recurred, causing severe cardiac decompensation with repeated resuscitation. As a bailout strategy, we performed aortic valve closure via transfemoral retrograde implantation of an Amplatzer Duct Occluder II device. This led to the patient’s rapid stabilization while circumventing highly risky renewed surgery in such a critically ill infant. CONCLUSIONS: Retrograde transcatheter aortic valve closure may be considered a feasible alternative in infants with a failing single ventricle due to aortic regurgitation, with critical device evaluation being crucial for successful device implantation in this young age group. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13256-019-2141-5) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-17 /pmc/articles/PMC6635989/ /pubmed/31311582 http://dx.doi.org/10.1186/s13256-019-2141-5 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Fürniss, Hannah E.
Kubicki, Rouven
Stiller, Brigitte
Reineker, Katja
Siepe, Matthias
Grohmann, Jochen
Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title_full Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title_fullStr Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title_full_unstemmed Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title_short Retrograde transcatheter aortic valve closure in an infant with failing Norwood stage I palliation: a case report
title_sort retrograde transcatheter aortic valve closure in an infant with failing norwood stage i palliation: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635989/
https://www.ncbi.nlm.nih.gov/pubmed/31311582
http://dx.doi.org/10.1186/s13256-019-2141-5
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