Transcatheter aortic valve implantation with preexisting mechanical mitral prosthesis - use of CT angiography.

A 72-year-old Chinese female with prior mitral valve replacement with a mechanical prosthesis 13 years before was diagnosed with severe symptomatic aortic stenosis. She was considered a high-risk surgical candidate and was considered for transcatheter aortic valve implantation using a balloon-expandable device. The close proximity of the non-compliant mechanical mitral prosthesis to the aortic annulus raised concerns that the deployment of the device may be affected. Gated cardiac computed tomographic angiography was used to assess the distance between the mitral prosthesis and the aortic annulus. Transcatheter aortic valve implantation using the transapical approach was subsequently performed successfully.