This paper reports a case of severe stenosis and calcification of functional bicuspid aortic valve treated with transcatheter aortic valve replacement (TAVR). Before the operation, echocardiography and multi-detector computed tomography were used to evaluate the ascending aorta, coronary artery, iliac artery anatomy, valve morphology, and valve calcification. During the operation, femoral artery perforation occurred after suturing the puncture site. The treatment of compression and hemostasis with peripheral balloon was performed. After the operation, neuropsychiatric symptoms appeared. The result of brain MRI indicated multiple acute cerebral infarction. Anticoagulant, antiplatelet, and neurotrophic drugs were used. After 1-year follow-up, echocardiography showed a little reflux signal around the artificial aortic valve, and the patient’s nervous system examination showed no obvious abnormality. TAVR indications will continue to expand in the near future with the innovation of evaluation, devices, and technology. The summary of operation data can promote progress of TAVR and reduce the occurrence of complications.
The implantation of bioprosthetic heart valves have increased dramatically due to the aging population and the widespread application of transcatheter aortic valve replacement (TAVR). TAVR is increasingly being used in younger, lower-risk patients with a longer life expectancy, so it is important to overcome structural valve degeneration and ensure long-term TAVR durability. Although the mid-term durability results of the TAVR valve are encouraging, its long-term durability needs to be further explored. This article will mainly introduce the influencing factors of TAVR valve durability, evaluation criteria for structural valve degeneration, clinical research results related to TAVR valve durability, and problems to be solved.
