The role of echocardiography and CT angiography in transcatheter aortic valve implantation patients

The transcatheter aortic valve implantation （TAVI） consist an altemative treatment in patients with severe aortic stenosis. Multimodality imaging using transthoracic echocardiography （TTE） or transesophageal echocardiography （TOE） and multislice CT （MSCT） constitute cornerstone techniques for the pre-operative management, peri-procedural guidance, follow up and recognition of possible transcatheter valve related complications. CT angiography is much more accurate regarding the total definition of aortic annulus diameter and circumferential area. Two-dimensional （2D） echocardiography, underestimates the aortic valve annulus diameter compared to 3D imaging techniques （MSCT, MRI and 3D TOE）. Three-dimensional TOE imaging provides measurements of the aortic valve annulus similar to those delivered by MSCT. The pre-procedural MSCT constitutes the gold standard modality minimizing the presence of paravalvular aortic regurgitation, one of the most frequent complications. TOE/TTE and MSCT performance could predict the possibility of pacemaker implantation post-procedural. The presence of a new transient or persisting MR can be assessed well by TOE. Both TTE and TOE, consist initially the basic examination for post TAVI evaluation. In case of transcatheter heart valve failure, the MSCT could be used as additional imaging technique.

Restrictive perimembranous ventricular septal defect with left to right Shunt post urgent aortic balloon valvuloplasty and transcatheter aortic valve replacement

An 86-year-old male patient was admitted in our cardiology ward with signs of congestive biventricular heart failure. The patient presented with deteriorating dyspnea on mild exertion and at rest the last days, compatible with class NYHA Ⅲ-Ⅳ heart failure, bilateral peripheral oedema, increased NT-proBNP （9198 pg/mL）, mildly elevated Troponin （TnT 64 pg/mL）, interstitial pulmonary oedema and bilateral pleural effusions in chest X ray.

Transcatheter Valve-in-Valve implantation after late migration of balloon expandable Sapien- XT prosthesis in a severe pure aortic regurgitation case

A 76-year old female, was admitted in our cardiac surgery clinic to perform surgical aortic valve replacement due to a severe aortic regurgitation with symptoms of congestive heart failure. Her past medical history included moderately impaired renal function （GFR 48 mL/min） and arterial hy- pertension.

Early prosthetic valve endocarditis after transcatheter aortic valve implantation with periannular complication

Prosthetic valve endocarditis （PVE） after Transcatheter Aortic Valve Implantation （TAVI） has been reported to occur with an incidence of 0.3% 3.1% per patient-year and it is associated with high mortality rates. We report a PVE occurring early, i.e., 26 days post transfemoral TAVI with the use of Edward-Sapien-XT S3 prosthesis 26 mm because of severe symptomatic aortic tory included a coronary and stenosis. His past medical his- peripheral arterial disease and a total knee replacement in 2010. Our patient, a 77-year old female, was admitted with signs of septic arthritis of the left knee and was febrile.

Endocarditis after transcatheter aortic valve implantation： a current assessment

1 Introduction Transcatheter aortic valve implantation （TAVI） constitutes an established treatment in inoperable or high perioperative risk patients with severe aortic stenosis, demonstrating similar mortality rates （at 30 days and 1 year） with surgical aortic valve replacement （SAVR）. Various complications have been reported during TAVI, weeks or months post procedure. The most frequent causes of transcatheter heart valve （THV） failure are paravalvular regurgitation, infective endocarditis （IE）, thrombosis and late valve Migration.