{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:54:40Z","timestamp":1788447280038,"version":"build-2803163510"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There have been few reports on transcatheter aortic valve implantation (TAVI) for patients with severe aortic stenosis (AS) and a membranous ventricular septal aneurysm (MSA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 77-year-old female complaining of dyspnoea was transferred to our hospital. Transthoracic echocardiography (TTE) showed progressive very severe AS with reduced left ventricular (LV) systolic function. The patient was scheduled for TAVI due to high surgical risk. Preoperative computed tomography showed a MSA located between the right coronary cusp and the non-coronary cusp, therefore a part of the annulus rim was lacking. We draw a virtual annulus line to assess her true annulus size and selected a 29\u2005mm size of Evolut Pro Plus. Since the bottom end of the valve was positioned into the MSA, the valve was begun to expand with a lack of coaxiality and massive paravalvular leak (PVL) occurred. Therefore, we decided to retrieve the 29\u2005mm valve. An up-sized 34\u2005mm Evolut was tried, but it was too large and caused the phenomenon of stent-frame infolding. We had to retrieve the 34\u2005mm valve again, and tried to deploy another 29\u2005mm valve at a position as high as possible and pushed the delivery system during the final release to maintain good coaxiality. Postoperative TTE showed significant recovery of LV systolic function, and the PVL was mild.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>In patients with both MSA and severe AS, it is difficult to measure the precise annulus size for ensuring stability of the self-expanding valve and preventing PVL.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf230","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T18:19:34Z","timestamp":1746728374000},"source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter aortic valve implantation for a patient with both severe aortic stenosis and membranous ventricular septal aneurysm: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0558-4432","authenticated-orcid":false,"given":"Naoto","family":"Murakami","sequence":"first","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine , South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Kokubu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine , South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsaku","family":"Otomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine , South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0145-3541","authenticated-orcid":false,"given":"Masato","family":"Furuhashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine , South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2025052601114707100_ytaf230-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4330\/wjc.v10.i1.1","article-title":"Transcatheter aortic valve replacement in membranous interventricular septum aneurysm with left ventricular outflow tract extension","volume":"10","author":"Bnaga","year":"2018","journal-title":"World J Cardiol"},{"key":"2025052601114707100_ytaf230-B2","doi-asserted-by":"crossref","first-page":"e231215","DOI":"10.1136\/bcr-2019-231215","article-title":"TAVR in a patient with a membranous ventricular septal aneurysm identified during cardiac CT","volume":"12","author":"Hawa","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025052601114707100_ytaf230-B3","first-page":"e197117","article-title":"Trancatheter aortic valve implantation for severe aortic stenosis and large membranous interventricular septal aneurysm","volume":"49","author":"Gedela","year":"2022","journal-title":"Tex Heart Inst J"},{"key":"2025052601114707100_ytaf230-B4","doi-asserted-by":"crossref","first-page":"102715","DOI":"10.1016\/j.jaccas.2024.102715","article-title":"Transcatheter aortic valve replacement in patients with interventricular membranous septal aneurysms","volume":"30","author":"Theriault-Lauzier","year":"2025","journal-title":"JACC Case Rep"},{"key":"2025052601114707100_ytaf230-B5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3941\/jrcr.v8i5.1715","article-title":"Magnetic resonance imaging of AMS (aneurysm of the membranous septum), review of the literature and case report","volume":"8","author":"Di Cesare","year":"2014","journal-title":"J Radiol Case Rep"},{"key":"2025052601114707100_ytaf230-B6","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1161\/01.CIR.49.2.375","article-title":"The natural history of the so-called aneurysm of the membranous ventricular septum in childhood","volume":"49","author":"Freedom","year":"1974","journal-title":"Circulation"},{"key":"2025052601114707100_ytaf230-B7","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.4244\/EIJ-D-21-00363","article-title":"Membranous septum morphology and risk of conduction abnormalities after transcatheter aortic valve implantation","volume":"17","author":"J\u00f8rgensen","year":"2022","journal-title":"Eurointervention"},{"key":"2025052601114707100_ytaf230-B8","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s40119-021-00223-9","article-title":"Expert consensus on sizing and positioning of SAPIEN 2\/Ultra in bicuspid aortic valves","volume":"10","author":"Blackman","year":"2021","journal-title":"Cardiol Ther"}],"container-title":["European Heart Journal - 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