# Redo‐TAVR for bioprosthetic valve degeneration with obvious neoplasm in a left cerebral infarction patient

## TL;DR

This case report describes a successful Redo-TAVR procedure in a patient with a degenerated bioprosthetic valve, cerebral infarction, and renal insufficiency.

## Contribution

The novelty lies in performing Redo-TAVR without imaging and using protective devices to manage a neoplasm near the aortic valve.

## Key findings

- Redo-TAVR was successfully performed using CT guidance and protective devices in a high-risk patient.
- The patient's symptoms of chest tightness and suffocation improved significantly post-surgery.
- The use of cerebral and coronary protection devices prevented potential embolism from a neoplasm.

## Abstract

In recent years, it is necessary to Redo‐TAVR for the patients with bioprosthetic valve degeneration. This case report described a unique instance to successfully Redo‐TAVR a patient with bioprosthetic valve degeneration, in addition, with left cerebral infarction and renal insufficiency.

Over time, more and more patients have bioprosthetic valve degeneration either used in SAVR or TAVR. In order to solve the produced problems due to the degenerated bioprosthetic valve, Redo‐TAVR was increasingly popular due to its safe and efficiency especially for the high risk and complicated symptoms patients. In this case, the patient with left cerebral infarction and renal insufficiency has exhibited severe regurgitation and obvious neoplasm around the previous replaced aortic valve. For the patient with complicated symptoms, we did not image for this patient and only used CT to determine the position and angle for the Redo‐TAVR on the base of metal stent for the previous replaced aortic valve. During the Redo‐TAVR process, for fear of the obvious neoplasm slipping from the previous replaced aortic valve to embolism of important organs, before carrying out the Redo‐TAVR, cerebral protection device, temporary pacemaker, and coronary artery protection device were utilized in order to avoid the damage for the important organs from the obvious neoplasm slipping from the previous replaced aortic valve. The surgery was successful and the patient recovered well. The patient's symptoms of chest tightness and suffocation have been greatly reduced.