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In the valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) era, implanting a larger-sized valve during the initial aortic valve replacement is important. For smaller aortic annuli, combining aortic annular and left ventricular outflow tract (LVOT) enlargement is essential. The Y-incision procedure helps achieve implantation of a 2-size larger valve.

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Transcatheter Bailout: An Important Option During Complex Aortic Surgery.

Ann Thorac Surg Short Rep

December 2024

Division of Adult Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.

This report presents the case of a 66-year-old man with acute torrential aortic insufficiency after a Ross procedure 20 years earlier, a biologic aortic valve replacement 16 years earlier, and a transcatheter valve-in-valve 4 years earlier. He underwent third-time sternotomy, revealing that the pulmonary autograft was heavily calcified and frozen to the homograft. The previous transcatheter valve-in-valve was explanted.

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We report a case of a woman who underwent mitral ring and tricuspid annuloplasty. Two months later, she presented with acute heart failure secondary to severe aortic regurgitation, which was a complication of the cardiac surgery. Given the high surgical risk of reoperation in this the patient, she underwent transcatheter aortic valve implantation, with a good result.

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A 90-year-old man received a diagnosis of ascending aortic pseudoaneurysms after transcatheter aortic valve implantation (TAVI) using an Evolut PRO valve (Medtronic). Plug closure of the pseudoaneurysms was successfully performed, and the symptoms improved after the procedure. However, on postoperative day 4, the patient experienced sudden massive hemoptysis and died.

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Background: Continuous retrograde flow across the aortic valve from left ventricular assist device (LVAD) therapy can result in cusp damage and progressive aortic regurgitation, potentially triggering recurrent heart and multiorgan failure. The management of aortic regurgitation after LVAD implantation has not been well defined.

Methods: This study retrospectively reviewed the investigators' experience with the management of de novo aortic regurgitation requiring intervention in patients with continuous-flow LVAD.

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