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Ann Thorac Surg 2007;83:284-287
© 2007 The Society of Thoracic Surgeons
a Department of Surgery, Montréal Heart Institute and "Université de Montréal," Montréal, Québec, Canada
b Department of Anesthesiology, Montréal Heart Institute and "Université de Montréal," Montréal, Québec, Canada
c Department of Cardiology, Montréal Heart Institute and "Université de Montréal," Montréal, Québec, Canada
d Department of Cardiology, Clinique Pasteur, Toulouse, France
Accepted for publication May 31, 2006.
* Address correspondence to Dr Bonan, Department of Medicine, Montréal Heart Institute, 5000 Belanger St, Montréal, Québec H1T1C8, Canada (Email: raoul.bonan{at}mmic.net).
Surgical aortic valve replacement is the only recommended treatment for significant aortic valve stenosis. Percutaneous aortic valve replacement appears to be a novel option for high-risk patients. We report the implantation of the ReValving system (CoreValve, Paris, France) in a 64-year-old woman who was refused aortic valve replacement surgery for critical aortic stenosis and left ventricular dysfunction because of severe pulmonary fibrosis. After anesthesia, the patient was put on femorofemoral cardiopulmonary bypass, and underwent a balloon valvuloplasty with subsequent retrograde aortic valve replacement by the ReValving system. Transesophageal echocardiographic monitoring of the patients hemodynamics showed immediate improvements of the valvular area and left ventricular ejection fraction and only traces of paravalvular leaks. The patient was easily weaned from ventilation and resumed activity soon after the surgery. A multidisciplinary approach is presently necessary to offer a reliable and safe procedure.
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