# Accelerated structural valve deterioration in systemic sclerosis patients following transcatheter aortic valve replacement: a case series

## TL;DR

Patients with systemic sclerosis may experience faster valve deterioration after TAVR, requiring repeat procedures and close monitoring.

## Contribution

Reports two cases of early structural valve deterioration in systemic sclerosis patients after TAVR, suggesting the need for tailored management.

## Key findings

- Two systemic sclerosis patients required redo-TAVR due to early structural valve deterioration.
- Soft tissue calcinosis in systemic sclerosis may affect TAVR durability.
- Redo-TAVR appears viable for managing valve failure in this patient group.

## Abstract

Systemic sclerosis (SSc) is marked by an excessive systemic accumulation of collagen. Recent literature implies that aortic stenosis is more prevalent in patients with SSc than previously thought. While there are limited feasibility studies on transcatheter aortic valve replacement (TAVR) in this population, the long-term outcomes remain uncertain.

We report two cases of patients with SSc who developed early structural valve deterioration following TAVR, necessitating successful redo-TAVR procedures. Both patients exhibited extensive soft tissue calcinosis as a manifestation of their underlying condition.

The fibrotic and calcific processes inherent to certain SSc subtypes could potentially adversely impact the durability and functionality of transcatheter aortic valves. Our observation highlights the need for vigilant post-procedural surveillance and individualized management strategies in this unique patient population. Further investigation into the mechanisms underlying valve degeneration in this patient subset is warranted. Nevertheless, redo-TAVR procedure appears to be a viable option.