scholarly journals TCTAP C-286 Successful Valve-in-Valve Implantation for Symptomatic Severe Paravalvular Aortic Regurgitation at Follow-up after Transcatheter Aortic Valve Replacement

2017 ◽  
Vol 69 (16) ◽  
pp. S373-S374
Author(s):  
Ungjeong Do ◽  
Minsoo Kim ◽  
Hanbit Park ◽  
Yong-Hoon Yoon ◽  
Sang-Cheol Cho ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals Early haemodynamic and structural impact of transcatheter aortic valve replacement in pure aortic regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Graziani ◽  
E Mencarelli ◽  
F Burzotta ◽  
L Paraggio ◽  
C Aurigemma ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Structural Impact ◽  
Before And After

Abstract Background Patients with severe aortic regurgitation (AR) are treated by surgery and have variable left-ventricular (LV) “reverse remodelling” after intervention. Transcatheter-aortic-valve replacement (TAVR) might be considered in selected AR patients. Purpose To evaluate the hemodynamic and structural impact of TAVR in patients with pure AR. Methods Consecutive AR patients underwent TAVR in our Institution were identified. Left heart catheterization before and after TAVR and complete echocardiographic assessment before TAVR, after (24–72 hours) TAVR and at follow-up (3–12 months) were systematically performed. Hemodynamic and echocardiographic parameters were compared before and after TAVR. Results Twenty-two patients with severe AR, high surgical risk and advanced heart damage were treated by TAVR using mainly self-expandable prostheses. The procedure was successful in 21 patients (95.5%). An immediate hemodynamic impact of the TAVR procedure was documented by different parameters and included significant decrease in LV end-diastolic pressure (from 26.2 to 20.1 mmHg, P=0.012). Significant reduction in LV size (left ventricular end diastolic diameter (LVEDD): 60.0±8.0 mm vs 54.6±8.1 mm, p=0.002) and mass (left ventricular mass indexed (LVMi): 163.2±58.8 g/m2 vs 140.2±45.6 g/m2, p 0.004) as well as a sharp reduction in systolic-pulmonary-arterial-pressure (48.3±17.6 vs 32.9±7.8 mmHg, p<0.0001) was documented at 24–72 hours. Furthermore, patients with baseline moderate-to-severe mitral and tricuspid regurgitation showed a significant, early, valvular regurgitation reduction. All favourable changes persisted at follow-up. More pronounced LVEDD reduction was predicted by baseline LVEDD (p=0.019). Conclusions In patients with severe AR, TAVR determines a profound impact on heart remodelling, which is early detectable and durable. Impact of TAVR in pure AR Funding Acknowledgement Type of funding source: None

scholarly journals Rescue Valve-in-Valve Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation

2017 ◽  
Vol 10 (3) ◽  
pp. e23-e24 ◽  
Author(s):  
Hidehiro Kaneko ◽  
Frank Hoelschermann ◽  
Grit Tambor ◽  
Michael Neuss ◽  
Christian Butter
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve

Small Degenerated Surgical Bioprosthetic Valve should be Treated with SupraAnnular Valve-in-Valve Transcatheter Aortic Valve Replacement

2021 ◽  
Author(s):  
Frane Runjic ◽  
◽  
Andrija Matetic ◽  
Matjaz Bunc ◽  
Nikola Crncevic ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Therapeutic Option ◽  
Bioprosthetic Valve ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve ◽  
Bioprosthetic Valves

Background: Patient-prothesis mismatch (PPM) is a serious potential complication following surgical aortic valve replacement (SAVR). If it develops, valve-in-valve transcatheter aortic valve replacement (TAVR) is a reasonable therapeutic option. However, there is low evidence on the management of small degenerated surgical bioprosthetic valves, not prone to balloon-valve fracture (BVF). Case Presentation: This case report presents a successful valve-in-valve TAVR in acute heart failure due to degenerative surgical bioprosthetic valve Trifecta (21 mm) that is not susceptible to BVF. Standard preparation for transfemoral TAVR with a self-expandable valve was conducted, including the over-the-wire pacing. Thereafter, a successful valve-in-valve primary implantation of the self-expanding, supra-annular valve Evolut R 26 (Medtronic™) has been achieved. Follow-up at 3 months showed mild paravalvular leak in the region with clinical and heart function improvements of the patient. Follow-up echocardiographic parameters showed the reduction of anterograde flow impairment and improved effective orifice area (~0.85 cm2/m2). Conclusion: In conclusion, supra-annular valve-in-valve TAVR is a potential therapeutic option for PPM of small degenerated surgical bioprosthetic valves which are not prone to BVF.

scholarly journals Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical Aortic Valve Replacement

2021 ◽  
Vol 14 (2) ◽  
pp. 211-220 ◽  
Author(s):  
Michel Pompeu B.O. Sá ◽  
Jef Van den Eynde ◽  
Matheus Simonato ◽  
Luiz Rafael P. Cavalcanti ◽  
Ilias P. Doulamis ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve

scholarly journals More in, better out? Successful valve-in-valve procedure of an iatrogenic ventricular septal defect following transcatheter aortic valve replacement: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Klaus-Dieter Hönemann ◽  
Steffen Hofmann ◽  
Frank Ritter ◽  
Gerold Mönnig
Keyword(s):  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Septal Defect ◽  
Left Ventricular ◽  
Heart Team ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve

Abstract Background A rare, but serious, complication following transcatheter aortic valve replacement (TAVR) is the occurrence of an iatrogenic ventricular septal defect (VSD). Case summary We describe a case of an 80-year-old female who was referred with severe aortic stenosis for TAVR. Following thorough evaluation, the heart team consensus was to proceed with implantation via a transapical approach of an ACURATE neo M 25 mm valve (Boston Scientific, Natick, MA, USA). The valve was deployed harnessing transoesophageal echocardiographic (TOE) guidance under rapid pacing with post-dilation. Directly afterwards a very high VSD close to the aortic annulus was detected. As the patient was haemodynamically stable, the procedure was ended. The next day another TOE revealed a shunt volume (left-to-right ventricle) between 50% and 60%. Because the defect was partly located between the stent struts of the ACURATE valve decision was made to fix this leakage with implantation of a further valve and we chose an EVOLUT Pro 29 mm (Medtronic Inc., Minneapolis, MN, USA). The valve-in-valve was implanted 2–3 mm below the lower edge of the first valve, more towards the left ventricular outflow tract (LVOT) with excellent result: VSD was reduced to a very small residual shunt without any hemodynamic relevance. Discussion We suggest that an iatrogenic VSD located near the annulus may be treated percutaneously in a bail-out situation with implantation of a second valve that should be implanted slightly more into the LVOT to cover the VSD.

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