Percutaneous transcatheter double valve implantation under conscious sedation complicated by mitral bioprosthesis migration

Abstract

This unique case demonstrates the safe and effective nature of transcatheter aortic and mitral valve implantation in the same sitting under conscious sedation with transoesophageal echocardiogram guidance in a patient at prohibitively high risk of redo surgery and general anaesthesia. Performing double valve implantation under conscious sedation allowed a reduced length of hospital stay with discharge less than 24 hours after the procedure. Follow-up at 3 years was extremely favourable with improvement to New York Heart Association class I symptoms, no intervening admissions for decompensated heart failure and a reduction in baseline diuretic usage-indicating the viable role for these procedures in the future. Appropriate pre-procedural planning and cohesive heart valve team working is essential to carry out these high-risk procedures.

Keywords: Interventional cardiology; Valvar diseases.