Surgery for delayed leaflet impingement after transcatheter closure of a paravalvular leak associated with an aortic pseudoaneurysm.

Background: Paravalvular leak (PVL) is a recognized and challenging complication after surgical or transcatheter valve replacement. The transcatheter closure of PVL has become the first-line treatment in clinical practice when the procedure is not contraindicated. Transcatheter PVL closure rests on a complex procedure and complications still occur in approximately 9% of patients. Case Report: We describe the case of a delayed mechanical prosthetic leaflet impingement after transcatheter closure of a paravalvular leak associated with a Valsalva pseudoaneurysm that required an urgent surgery. Conclusion: Aorta-left ventricle communication could be a relative contraindication to be assessed on a case-by-case basis, but transcatheter closure does not preclude subsequent attempt for surgical repair and outcome.

Postinflammatory rupture of right coronary artery ostium complicating Behçet disease.

INTRODUCTION: Behçet disease (BD) is a chronic relapsing inflammatory disease of unknown etiology, characterized by variable clinical manifestations. METHODS: A 28-year-old woman with BD Cardiovascular and Bipolar Disorder underwent emergency surgical treatment of ascending aortic pseudoaneurysm for ruptured right coronary ostium.A modified Bentall procedure with tricuspid annuloplasty, surgical thrombectomy, and a single coronary artery bypass using a saphenous vein graft was performed. A biological prosthesis was used initially but subsequently deteriorated. We then successfully performed a valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI). RESULTS: The postoperative recovery was uneventful and at follow-up, two years post valve procedure, the patient was completely symptom-free. She remains under long-term medical surveillance. CONCLUSION: The management of BD with cardiac involvement must be led by a multidisciplinary team.