Successfully minimal approach ViV-TAVR without angiography in a severe restenosis with renal dysfunction 17 years post-surgical aortic valve replacement: A case report

Abstract

Severe aortic stenosis (AS) is a major cause of morbidity and mortality in the elderly. Transcatheter aortic valve replacement (TAVR) is an approach in cardiovascular interventional therapy. As we known, most of the candidates for TAVR are suffered from advanced heart dysfunction (New York Heart Association functional class III or IV) and chronic kidney disease. However, contrast-enhanced computed tomography and coronary angiography are necessary for pre-procedures for TAVR. TAVR could have adverse effects on kidney function including contrast-induced acute kidney injury (CI-AKI), which is related to poor prognosis. In a severe recurrent valve stenosis with progressive renal dysfunction, receiving surgical aortic valve replacement (SAVR) using bioprosthetic valve (BV) 17 years ago, we successfully reversed restenosis by performing pre-procedure evaluating and valve-in-valve (ViV) TAVR without angiography. Angiography-free TAVR may be a beneficial approach for patients with aortic restenosis after SAVR complicated with renal dysfunction.