Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2018; 10(1): 1-5
Published online Jan 26, 2018. doi: 10.4330/wjc.v10.i1.1
Transcatheter aortic valve replacement in membranous interventricular septum aneurysm with left ventricular outflow tract extension
Sandeep Banga, Marco A Barzallo, Casey L Nighswonger, Sudhir Mungee
Sandeep Banga, Marco A Barzallo, Sudhir Mungee, Division of Cardiology, Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL 61637, United States
Sandeep Banga, Marco A Barzallo, Casey L Nighswonger, Sudhir Mungee, Osf St. Francis Medical Center, Peoria, IL 61637, United States
Author contributions: Banga S reviewed the literature and wrote the manuscript; Barzallo MA and Mungee S operated the patient and revised the manuscript; Nighswonger CL helped in getting consent from the patient and image collection.
Informed consent statement: All patients identifiable information has been anonymized in this case report. The patient provided informed written consent for their case to be written up.
Conflict-of-interest statement: All the authors have nothing to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sandeep Banga, MD, Doctor, Division of Cardiology, Department of Internal Medicine, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Ave, Peoria, IL 61637, United States. drsbanga@gmail.com
Telephone: +1-309-5506820 Fax: +1-309-6557732
Received: December 7, 2017
Peer-review started: December 8, 2017
First decision: December 11, 2017
Revised: December 25, 2017
Accepted: January 16, 2018
Article in press: January 16, 2018
Published online: January 26, 2018
Abstract

We report a challenging case of a 81-year-old male with history of severe calcific aortic valve stenosis and aneurysmal membranous interventricular septum. The presence of anomalies in the sub-annular area can lead to valve malpositioning and its consequences. Transcatheter aortic valve implantation (TAVR) in patients with aneurysm of the perimembranous interventricular septum extending into the left ventricular outflow tract has not been previously reported. This case describes a successful transfemoral TAVR with an Edwards SAPIEN XT valve (Edwards Lifesciences, Irvine, CA, United States) with such anomaly.

Keywords: Transcatheter aortic valve replacement, Aneurysmal membranous interventricular septum

Core tip: Congenital perimembranous ventricular septal aneurysm is reported to be rare and its co-occurrence with severe calcific aortic stenosis is even rarest. This unique case establishes that the transcatheter aortic valve replacement can be done in patients with aneurysmal perimembranous interventricular septum. This was achieved in our case by implanting the prosthetic valve more distally into the left ventricular outflow tract requiring apposition of the Edwards SAPIEN XT skirt at annulus with most of the valvular metallic frame in supra-annular position.