Pulmonary valve-in-valve procedure after fractured biological prosthetic valve

Percutaneous therapies for congenital heart disease have been evolving rapidly despite limited investment from industry. The Melody transcatheter pulmonary valve (Medtronic, Inc, Minneapolis, MN USA) replacement therapy represents an important advancement in this arena. It has been approved in the United States for use in the pulmonary position, on a Humanitarian Device Exemption status. Off-label use of the Melody transcatheter pulmonary valve has extended to the mitral, pulmonary, and aortic valves, especially in previously implanted valves with prosthetic valve degeneration. The single-ventricle patient poses additional challenges. However, there exists one report in the English literature of a patient undergoing Melody transcatheter neoaortic valve replacement after the patient developed severe neoaortic regurgitation after Fontan palliation. Here, we describe a patient with hypoplastic left heart syndrome, palliated with a Norwood modified Blalock-Taussig shunt, with a progressively regurgitant quadricusp neoaortic valve who underwent bioprosthetic valve replacement. There was early prosthetic valve degeneration after a year of bioprosthesis implantation. As he was declined for transplantation, he underwent successful perventricular Melody valve-in-valve replacement.

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Transcatheter Valve-in-Valve Implantation for Early Prosthetic Valve Degeneration in Aortic and Mitral Positions

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2013.09.061 ◽

2014 ◽

Vol 98 (1) ◽

pp. 318-321 ◽

Cited By ~ 2

Author(s):

Kentaro Yamane ◽

Tamim M. Nazif ◽

Omar Khalique ◽

Rebecca T. Hahn ◽

Martin B. Leon ◽

...

Keyword(s):

Prosthetic Valve ◽

Valve In Valve ◽

Transcatheter Valve ◽

Valve Implantation

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Simultaneous Aortic Valve-in-Valve and Ascending Stent Grafting for Prosthetic Valve Stenosis and Ascending Flap

Annals of Vascular Diseases ◽

10.3400/avd.cr.20-00065 ◽

2020 ◽

Vol 13 (4) ◽

pp. 422-425

Author(s):

Yoshiyuki Yamashita ◽

Kazuo Shimamura ◽

Koichi Maeda ◽

Yu Yamada ◽

Toru Ide ◽

...

Keyword(s):

Aortic Valve ◽

Prosthetic Valve ◽

Stent Grafting ◽

Valve In Valve

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Interventional Echocardiography of the MV: What the Interventionalist Wants to Know

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253218778822 ◽

2018 ◽

Vol 23 (1) ◽

pp. 37-47 ◽

Cited By ~ 2

Author(s):

Ludmil Mitrev ◽

Nayan Desai ◽

Ahmed Awad ◽

Sajjad Sabir

Keyword(s):

Mitral Valve ◽

Prosthetic Valve ◽

The Past ◽

Interventional Echocardiography ◽

Valve In Valve ◽

Procedural Guidance ◽

Valve Implantation ◽

Transcatheter Interventions

The past 2 decades have seen a proliferation of transcatheter mitral valve (MV) therapies, which are less invasive and distinct from surgical MV repair or replacement. The commonly used MV transcatheter therapies include (1) percutaneous mitral balloon commissurotomy (PMBC) for rheumatic mitral stenosis; (2) edge-to-edge repair with the MitraClip for mitral regurgitation; (3) valve-in-valve implantation in bioprosthetic MV, native MV, or mitral ring; and (4) closure of paravalvular leaks (PVLs). This article will focus on the use of echocardiography in the diagnosis, patient selection, procedural guidance, and postprocedural follow-up for PMBC, with notes on the role of transesophageal echocardiography in transcatheter interventions for prosthetic valve degeneration and PVL closure.

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Ross Procedure: How to Do It and How to Teach It

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135119852324 ◽

2019 ◽

Vol 10 (5) ◽

pp. 624-627

Author(s):

Jeremy L. Herrmann ◽

Amanda R. Stram ◽

John W. Brown

Keyword(s):

Aortic Valve ◽

Aortic Stenosis ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Prosthetic Valve ◽

Pulmonary Valve ◽

Prosthetic Graft ◽

Ascending Aorta ◽

Ross Procedure

Prosthesis choice for aortic valve replacement (AVR) in children is frequently compromised by unavailability of prostheses in very small sizes, the lack of prosthetic valve growth, and risks associated with long-term anticoagulation. The Ross procedure with pulmonary valve autograft offers several advantages for pediatric and adult patients. We describe our current Ross AVR technique including replacement of the ascending aorta with a prosthetic graft. The procedure shown in the video involves an adult-sized male with a bicuspid aortic valve, mixed aortic stenosis and insufficiency, and a dilated ascending aorta.

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Concomitant Valve-In-Valve Transcatheter Aortic Valve Replacement and Left Ventricular Assist Device Implantation

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000360 ◽

2017 ◽

Vol 12 (2) ◽

pp. 147-149 ◽

Cited By ~ 2

Author(s):

Takashi Murashita ◽

David L. Joyce ◽

Alberto Pochettino ◽

John M. Stulak ◽

Lyle D. Joyce

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Left Ventricular Assist Device ◽

Ventricular Assist Device ◽

Prosthetic Valve ◽

Left Ventricular ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

Valve In Valve

Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation. Transthoracic echocardiography results showed severe aortic prosthetic valve deterioration with moderate aortic regurgitation as well as severe left ventricular dysfunction (ejection fraction, 11%). After redosternotomy, we performed transcatheter AVR via the ascending aorta and subsequent LVAD implantation. The postoperative course was uneventful. Generally, patients with structural deterioration of a bioprosthetic valve who report for LVAD therapy present considerable challenges to the surgeon. Concomitant transcatheter AVR offers a less-invasive alternative to surgical AVR that minimizes ischemic injury to myocardium.

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TCT-767 Treatment of Bio-Prosthetic Valve Deterioration Using The Valve-in-Valve Technique

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2014.07.839 ◽

2014 ◽

Vol 64 (11) ◽

pp. B223-B224

Author(s):

Pablo Codner ◽

Abid Assali ◽

Hana Vaknin-Assa ◽

Yaron Shapira ◽

Gabriel Greenberg ◽

...

Keyword(s):

Prosthetic Valve ◽

Valve In Valve

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Percutaneous Management of Prosthetic Valve Dysfunction in Mitral Position: Transapical Mitral Valve-In-Valve Implantation

10.7775/rac.v87.i5.15630 ◽

2019 ◽

Vol 87 (5) ◽

pp. 380-382

Author(s):

Juan R. Alderete ◽

Alberto C. Anaya Revolledo ◽

Verónica I. Volberg ◽

Miguel Rubio ◽

Gustavo E. Barrera ◽

...

Keyword(s):

Mitral Valve ◽

Prosthetic Valve ◽

Valve Dysfunction ◽

Prosthetic Valve Dysfunction ◽

Mitral Position ◽

Valve In Valve ◽

Valve Implantation

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In vitro study of a biological prosthetic valve for seamless fixation

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2017-4-61-69 ◽

2018 ◽

Vol 19 (4) ◽

pp. 61-69

Author(s):

K. U. Klyshnikov ◽

E. A. Ovcharenko ◽

A. N. Stasev ◽

N. A. Scheglova ◽

Yu. N. Odarenko ◽

...

Keyword(s):

Prosthetic Valve ◽

In Vitro Study ◽

Cardiac Valve ◽

Breaking Force ◽

Heart Model ◽

Bovine Heart ◽

Combined Operation ◽

Valve In Valve

Aim: to evaluate the manipulative properties of the system being developed for cardiac valve re-operation on an in vitro bovine heart model.Material and methods. The prototype of the prosthesis being developed, mounted on the implant holder, as well as the dilatation balloon of its own design, were used as the objects of the study. The bioprosthesis «UniLine» of 21 mm size for the aortic position was chosen as the target site of implantation, which was established by the «classical» suture method. After that, the implantation of the tested device was carried out as a «valve in valve» and the quality of the installation and the combined operation of all the components of the re-prosthesis system were evaluated.Results. The test implantation demonstrated the consistency of the proposed method on the basis of balloon seamless ﬁ xation, as well as high ergonomic characteristics: the average time of seamless implantation of the developed prototype on an in vitro animal heart model was 3 minutes versus the implantation of the «UniLine» bioprosthesis – 11 min, Implantation provided a reliable prosthesis The breaking force was 12.9 N, which is equivalent to a pressure of 279 mm Hg.

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