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J Thorac Cardiovasc Surg 2009;138:1025-1027
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Aortic valve replacement and mitral valve repair as treatment of complications after percutaneous core valve implantation

^a Division of Cardiac Surgery, University of Turin, San Giovanni Battista Hospital, Turin, Italy
^b Division of Cardiology, San Giovanni Battista Hospital, Turin, Italy

Received for publication September 29, 2008; revisions received October 22, 2008; accepted for publication November 2, 2008.

^_* Address for reprints: Fabrizio Sansone, MD, Division of Cardiac Surgery, University of Turin, San Giovanni Battista Hospital, C.so Bramante 88/90, Turin, Italy. (Email: fabrisans@katamail.com).

The first 20% of the full text of this article appears below.

	Introduction

 
Standard aortic valve replacement is the gold standard for the treatment of severe aortic stenosis but transcatheter procedure can be performed in selected patients with important comorbidities or absolute contraindication for standard surgical approach. Careful multidisciplinary evaluation of each single case is fundamental in order to tailor the appropriate approach for every patient.

	Clinical Summary

 
We describe the case of a 66-year-old man who had surgical intervention for a core valve malfunction 3 months after transfemoral implantation. The patient was scheduled for percutaneous aortic valve implantation (PAVI) because of the presence of numerous risk factors, such as obesity (body mass index, 35%) and myelodysplasia. The main concern about elective standard aortic valve replacement was related to the patient's pulmonary function. As a result of a history of smoking and obesity, he had severe chronic pulmonary disease (forced expiratory volume in 1 second, <35%) and obstructive sleep apnea syndrome requiring noninvasive mechanical ventilation.

The patient presented with rapid worsening of dyspnea. An . . . [Full Text of this Article]