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  • Unusual cause of severe transvalvular eccentric jet AR: early structure valve deterioration of Trifecta valves by flail leaflet undergoing valve-in-valve transcatheter aortic valve replacement

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Case Reports: Unusual association of diseases/symptoms
Unusual cause of severe transvalvular eccentric jet AR: early structure valve deterioration of Trifecta valves by flail leaflet undergoing valve-in-valve transcatheter aortic valve replacement
  1. Thirath Chatlaong1,
  2. Paisit Kosum1,2,
  3. Monravee Tumkosit3,4 and
  4. Thitima Limjareon5,6
  1. 1Division of Cardiovascular Medicine, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  2. 2Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
  3. 3Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  4. 4Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  5. 5Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  6. 6Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  1. Correspondence to Dr Thitima Limjareon; Thitimamd{at}gmail.com

Abstract

The Trifecta tissue valve (Abbott, Illinois, USA) is an externally mounted bovine pericardial aortic valve (AV) prosthesis with adequate haemodynamic performance and better early results than another option. However, concerns have been raised about its durability. Recently, reports have emerged about an increased incidence of early structural valve failure after Trifecta implantation, where leaflet tear(s) with dehiscence along the stent post was the primary mode of early failure. In this article, we present the case of a patient in her 70s, 7 years after AV replacement with a Trifecta valve, who developed progressive dyspnoea. Physical examination revealed signs of chronic severe aortic regurgitation (AR). The initial transthoracic echocardiogram showed severe transvalvular AR, but the aetiology could not be determined. Cardiac computed tomography (CT) revealed a flail non-coronary cusp of the Trifecta bioprosthetic valve without vegetation. After discussion, we concluded that our patient was suitable for valve-in-valve transcatheter aortic valve replacement (ViV TAVR).

  • Interventional cardiology
  • Valvar diseases

https://doi.org/10.1136/bcr-2023-256369

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    Footnotes

    • Contributors TC, TL, PK and MT were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. TC, TL, PK and MT gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.