scholarly journals TCT-702 Multicenter Assessment of TAVR in Failed Aortic Bioprostheses: Evaluation of Implantation Depth and Association with Elevated Post-Procedural Gradients in SAPIEN vs. CoreValve Valve-in-Valve Implantation

2014 ◽  
Vol 64 (11) ◽  
pp. B206 ◽  
Author(s):  
Matheus S. Santos ◽  
John Webb ◽  
Ran Kornowski ◽  
Azeem Latib ◽  
Sabine Bleiziffer ◽  
...  
Keyword(s):  
Implantation Depth ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals Optimising the Haemodynamics of Aortic Valve-in-valve Procedures

2017 ◽  
Vol 12 (01) ◽  
pp. 40 ◽  
Author(s):  
Ren Jie Yao ◽  
Matheus Simonato ◽  
Danny Dvir ◽  
◽  
◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Standard Of Care ◽  
Common Adverse Event ◽  
Mechanical Valves ◽  
Transcatheter Heart Valve ◽  
Implantation Depth ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Bioprosthetic surgical valves are increasingly implanted during cardiac surgery, instead of mechanical valves. These tissue valves are associated with limited durability and as a result transcatheter valve-in-valve procedures are performed to treat failed bioprostheses. A relatively common adverse event of aortic valve-in-valve procedures is residual stenosis. Larger surgical valve size, supra-annular transcatheter heart valve type, as well as higher transcatheter heart valve implantation depth, have all been shown to reduce the incidence of elevated post-procedural gradients. With greater understanding of technical considerations and surgical planning, valve-invalve procedures could be more effective and eventually may become the standard of care for our increasingly ageing and comorbid population with failed surgical bioprostheses.

Transapical mitral valve in valve implantation

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
M Endlich ◽  
F Mellert ◽  
J Breuer ◽  
U Herberg ◽  
I Heinze ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve In Valve ◽  
Valve Implantation

Transapical mitral valve-in-valve implantation in patients with degenerated bioprostheses and high surgical risk

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
M Seiffert ◽  
L Conradi ◽  
S Baldus ◽  
J Schirmer ◽  
M Knap ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Valve In Valve ◽  
Valve Implantation

Transcatheter valve-in-valve implantation of the 'MedLab-KT' prosthesis

2020 ◽  
Vol 26 (1) ◽  
pp. 135
Author(s):  
A. B. Voevodin ◽  
A. A. Allenov ◽  
V. V. Bazylev
Keyword(s):  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

A valve-in-valve transcatheter aortic valve implantation with commissural alignment using advanced imaging reconstruction: a case report

2020 ◽  
Vol 3 (10) ◽  
pp. 01-05
Author(s):  
Marco Angelillis
Keyword(s):  
Aortic Valve ◽  
Severe Aortic Stenosis ◽  
Coronary Intervention ◽  
Easy Access ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Structural Valve Deterioration ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Transcatheter valve in valve (ViV) implantation actually represents a valid alternative to surgical reinterventions in patients with previous surgical aortic valve replacement (AVR). In patients less than 80 years old, it is crucial to correctly position the new valve leaving a feasible and easy access to coronary ostia, both for future percutaneous coronary intervention (PCI) than for a future possible TAVinTAV procedure. We report a 71 year old man with prior AVR presented with structural valve deterioration (SVD) leading to severe aortic stenosis. In order to guarantee comfortable coronary access we aligned, the commissures of the new percutaneous valve with the ones of the surgical bioprothesis by reconstructing the headframes of the surgical bioprosthesis with computer tomography (CT) and fluoro-CT.

scholarly journals Valve-in-valve transcatheter aortic valve implantation with fracturing of a failed small surgical aortic bioprosthesis: a case report

2020 ◽  
Author(s):  
Matjaz Bunc ◽  
Miha Cercek ◽  
Tomaz Podlesnikar ◽  
Simon Terseglav ◽  
Klemen Steblovnik
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Ex Vivo ◽  
Bioprosthetic Valve ◽  
Heart Team ◽  
Transcatheter Aortic Valve ◽  
Patient Prosthesis Mismatch ◽  
Valve In Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Failure of a small surgical aortic bioprosthesis represents a challenging clinical scenario with valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) often resulting in patient-prosthesis mismatch. Bioprosthetic valve fracture (BVF) performed as a part of the ViV TAVI has recently emerged as an alternative approach with certain types of surgical bioprostheses. Case summary An 81-year-old woman with a history of three surgical aortic valve procedures presented with heart failure. Aortic bioprosthesis degeneration with severe stenosis and moderate regurgitation was found. The patient was deemed a high-risk surgical candidate and the heart team decided that ViV TAVI was the preferred treatment option. Due to the very small 19 mm stented surgical aortic bioprosthesis Mitroflow 19 mm (Sorin Group, Italy) we decided to perform BVF as a part of ViV TAVI to prevent patient-prosthesis mismatch. Since this was the first BVF procedure in our centre, an ex vivo BVF of the same kind of bioprosthetic valve was performed first. Subsequently, successful BVF with implantation of Evolut R 23 mm (Medtronic, USA) self-expandable transcatheter valve was performed. Excellent haemodynamic result was achieved and no periprocedural complications were present. The patient had an immediate major improvement in clinical status and remains asymptomatic after 6 months. Discussion Bioprosthetic valve fracture together with ViV TAVI is a safe and effective emerging technique for treatment of small surgical aortic bioprosthesis failure. Bioprosthetic valve fracture allows marked oversizing of implanted self-expandable transcatheter aortic valves, leading to excellent haemodynamic and clinical results. An ex vivo BVF can serve as an important preparatory step when introducing the new method.

scholarly journals Implantation depth and its influence on complications after TAVI with self-expanding valves

2021 ◽  
Author(s):  
Philipp Breitbart ◽  
Jan Minners ◽  
Manuel Hein ◽  
Holger Schröfel ◽  
Franz-Josef Neumann ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Fusion Imaging ◽  
Paravalvular Leakage ◽  
Conduction Disturbances ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Implantation Depth ◽  
The Mean ◽  
Valve Implantation ◽  
To Receive

AbstractPrior studies in patients with transcatheter aortic valve implantation (TAVI) demonstrated an influence of transcatheter heart valve (THV) position on the occurrence of new conductions disturbances (CD) and paravalvular leakage (PVL) post TAVI in balloon-expandable valves (BEV). Purpose of this study was to investigate the THV implantation depth and its influence on the occurrence of CD and PVL in self-expanding valves (SEV). We performed fusion imaging of pre- and post-procedural computed tomography angiography in 104 TAVI-patients (all with Evolut R) to receive a 3-D reconstruction of the THV within the native annulus region. The THV length below the native annulus was measured for assessment of implantation depth. Electrocardiograms pre-discharge were assessed for conduction disturbances (CD), PVL was determined in transthoracic echocardiography. The mean implantation depth of the THV in the whole cohort was 4.3 ± 3.0 mm. Using the best cut-off of ≥ 4 mm in receiver operating characteristic curve analysis (sensitivity 83.3%, specificity 60.0%) patients with lower THV position developed more new CD after TAVI (68.2 vs. 23.7%, P < 0.001). A deep THV position was identified as the only predictor for new CD after TAVI (odds ratio [CI] 1.312[1.119–1.539], P = 0.001). The implantation depth showed no influence on the grade of PVL (r = 0.052, P = 0.598). In patients with TAVI using the Evolut R SEV, a lower THV positioning (≥ 4 mm length below annulus) was a predictor for new conduction disturbances. In contrast, implantation depth was not associated with the extent of PVL. Graphic abstract Prostheses positions of self-expanding valves and their influence on the occurrence of new conduction disturbances and the grade of paravalvular leakage after TAVI.

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