Performance of the Edwards Sapien 3 bioprosthesis in atrioventricular valve position: a case series

Abstract

Background The Edwards Sapien percutaneous valve (Edwards Lifesciences, Irvine, CA, USA) is a promising therapeutic option for congenital atrioventricular desease mostly because of the posibility to accomodate to somatic growth with ballon dilatation. Case Summary This article reports the performance of Edwards Sapien 3 valve in atrioventricular valve position in four paediatric patients. Discussion Despite aggressive antiplatelet and anticoagulation strategies, most patients showed early bioprosthesis dysfunction, with increasing gradient not related with somatic growth. The decrease in leaflet motility in the absence of thrombosis or pannus could be associated with the low velocity flow and low pressure gradient that exists between the atria and ventricles in small children. It is well known graft lifespam is ussually shorter in small children, but we hypothesise the possibility of a second factor, that valve design is intented to support higher flow velocity paterns, and can present a early failure in low flow low pressure situation. More studies are necessary to provide reliable evidence.