ArticleJACC. Case reports2025
Strategic Prosthesis Selection for Staged TAVI and Minimally Invasive Mitral Valve Surgery in a High-Risk Patient.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundIn high-risk patients with complex aorto-mitral pathologies, surgical planning must carefully consider both current and future procedural needs. When traditional double-valve surgery poses prohibitive risks, a staged approach (initial transcatheter aortic valve implantation [TAVI]) followed by endoscopic minimally invasive mitral valve surgery (MIC-MVS) can be an alternative. CASE HISTORY: A 65-year-old female patient with severe aortic stenosis and mitral stenosis underwent TAVI. Minimally invasive mitral valve surgery was planned 6 weeks later. During surgery, the high-profile TAVI prosthesis prevented sufficient aortic cross-clamping, leading to procedural adjustments and an extended intensive care unit recovery. DISCUSSION: This case emphasizes the importance of careful prosthesis selection in staged procedures. The complication of an obstructed aortic cross-clamp due to high-implanted, high-profile transcatheter prosthesis illustrates how prosthesis choice can significantly affect subsequent surgeries. Interdisciplinary collaboration between surgeons and cardiologists is essential to anticipate such issues and ensure optimal patient outcomes.
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