Successful transcatheter aortic valve in valve implantation for degenerated trifecta bioprosthesis in a patient with a coronary anomaly

Gen Thorac Cardiovasc Surg. 2021 Jul;69(7):1137-1139. doi: 10.1007/s11748-021-01621-5. Epub 2021 Mar 26.


We report a case of transcatheter aortic valve implantation in a 79-year-old woman with a coronary anomaly who underwent surgical aortic valve replacement with a 23-mm Abbott Trifecta bioprosthesis. The procedure was performed in response to severe aortic stenosis caused by a bicuspid aortic valve. Computed tomography showed an anomalous origin of the right coronary artery from the left coronary sinus, with an interarterial course. Although the virtual transcatheter valve to coronary ostium distance-right coronary artery was short, the right coronary artery ostium was just behind the stent post. The externally mounted leaflet was unable to reach the coronary orifice beyond the stent post. This case highlights a successful transcatheter aortic valve implantation for stented bioprostheses with externally mounted leaflets when the virtual transcatheter valve to coronary ostium distance is shortened by a coronary anomaly.

Keywords: Coronary anomaly; Trifecta; Valve in valve.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Bioprosthesis*
  • Female
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis*
  • Humans
  • Prosthesis Design
  • Prosthesis Failure
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome