Fast Valve Degeneration after Transcatheter Aortic Valve Replacement in a Hemodialysis Patient - Abstract
Transcatheter aortic valve replacement (TAVR) for severe aortic stenosis has been proven to be a safe therapeutic and well-established option in patients at high and intermediate surgical risk. TAVR shows a comparable mid-term durability compared to surgical aortic valve replacement. Only minimal data exist in the long-term survival of dialysis patients after cardiac valve replacement. Long-term function of TAVR devices in patients requiring hemodialysis remains unknown. We are presenting a case of early deterioration of a bioprosthetic CoreValve in a patient undergoing hemodialysis. The patient was scheduled for re-TAVR, unfortunately, the patient´s course deteriorated and cardiopulmonary resuscitation was unsuccessful. The autopsy revealed a severely denaturated CoreValve prosthesis with severe calcifications. In the subset of patients with renal failure however valve performance has to be regularly monitored for early signs of degeneration. Our case shows that the long-term performance of first generation TAVR devices in a patient requiring hemodialysis was limited.