Successful Transfemoral Edwards Sapien Aortic Valve Implantation in a Patient with Previous Mitral Valve Replacement

Transcatheter aortic valve implantation (TAVI) is a new method for patients with severe aortic stenosis at high surgical risk, such as previous cardiac surgery. The presence of mechanical mitral prosthesis might complicate TAVI because of possible interference between the both prosthesis. Some reports have already demonstrated the feasibility of TAVI in such patients. We report our experience with TAVI in a patient with severe symptomatic aortic stenosis who has had two previous cardiac surgeries with two mitral valve replacement due to recurrent endocarditis. The Edwards Sapien (Edwards Lifesciences, Inc., Irvine, California) valve via transfemoral approach was successfully implanted. We observed no deformation or dysfunction of the both prosthesis. Balloon valvuloplasty prior to implantation helps to observe the mutual effect of the new aortic valve and preexistent mitral prosthesis. We conclude that TAVI can be safely and successfully performed in patients with mechanical mitral prosthesis carefully considering the altered anatomical conditions.