High-pressure balloon fracturing of small dysfunctional Mitroflow bioprostheses facilitates transcatheter aortic valve-in-valve implantation

Nielsen‐Kudsk, Jens Erik; Andersen, Asger; Therkelsen, Christian Juhl; Christensen, Evald Høj; Jensen, Kimmo; Krusell, Lars Romer; Tang, Mariann; Terp, Kim; Klaaborg, Kaj-Erik; Greisen, Jacob; Nørgaard, Bjarne Linde; Andersen, Henning

doi:10.4244/eij-d-17-00244

Cited by 47 publications

(36 citation statements)

References 10 publications

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“…Nineteen millimeter valves present a greater challenge because the true internal diameter is in the 15.4–17 mm range thus severely limiting choice in valve sizes. This report expands on the two major published similar case series which included up to 25 mm valve sizes, and confirms that a valve fracture approach is clinically effective in these patients. The authors comment on valve selection, choosing the self‐expanding 23 mm Core valve Evolut‐R device for a supraannular implant in 4/5 patients and a 20 mm Sapien 3 THV in the remaining patient with low coronary height.…”

supporting

confidence: 83%

“Expanding the frame” for valve‐in‐valve therapy in small bioprostheses: Encouraging signs for the road ahead

Chatterjee

Hillegass

2018

Cathet Cardio Intervent

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supporting

confidence: 83%

“Expanding the frame” for valve‐in‐valve therapy in small bioprostheses: Encouraging signs for the road ahead

Chatterjee

Hillegass

2018

Cathet Cardio Intervent

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“…The procedural and haemodynamic results of patients who have been treated with VIV TAVR and BVF in two published case series are displayed in Table 2. 22,23 A total of 30 patients with a mean age of 79.0 years were treated with VIV TAVR for failed BPVs. The majority of cases were performed to treat BPV stenosis, with a mean time from SAVR implant to VIV TAVR of 10.4 years.…”

Section: Clinical Experiencementioning

confidence: 99%

Bioprosthetic Valve Fracture During Valve-in-valve TAVR: Bench to Bedside

Saxon

Allen

Cohen

et al. 2017

Interventional Cardiology Review

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Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) has been established as a safe and effective means of treating failed surgical bioprosthetic valves (BPVs) in patients at high risk for complications related to reoperation. Patients who undergo VIV TAVR are at risk of patient-prosthesis mismatch, as the transcatheter heart valve (THV) is implanted within the ring of the existing BPV, limiting full expansion and reducing the maximum achievable effective orifice area of the THV. Importantly, patient-prosthesis mismatch and high residual transvalvular gradients are associated with reduced survival following VIV TAVR. Bioprosthetic valve fracture (BVF) is as a novel technique to address this problem. During BPV, a non-compliant valvuloplasty balloon is positioned within the BPV frame, and a highpressure balloon inflation is performed to fracture the surgical sewing ring of the BPV. This allows for further expansion of the BPV as well as the implanted THV, thus increasing the maximum effective orifice area that can be achieved after VIV TAVR. This review focuses on the current evidence base for BVF to facilitate VIV TAVR, including initial bench testing, procedural technique, clinical experience and future directions.

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“…Also discussed is the benefit of using a bioprosthetic aortic valve with supra-annular leaflet positioning (e.g., CoreValve Evolut, Medtronic, Minneapolis, MN, USA) in order to obtain a larger EOA due to the supra-annular position of the prosthetic leaflets, and a higher valve implant depth which may improve inflow dynamics and augment the effective EOA [13][14][15][16][17]. This was the reason we decided to use the Medtronic CoreValve instead of an Edwards SAPIEN valve (Edwards LifeSciences, Irvine, CA, USA) in our patient.…”

Section: Discussionmentioning

confidence: 99%

Valve-in-Valve-in-Valve: Degenerated Transcatheter Heart Valve within Degenerated Surgical Bioprosthetic Aortic Valve Treated with Second Transcatheter Heart Valve

Ajmal

Reddy

Shetty

et al. 2020

Reports

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Currently, transcatheter aortic valve replacements within degenerated surgical bioprosthetic aortic valves (valve in valve) are increasing in frequency with studies supporting their safety and efficacy. We present the rare case of a patient requiring a second transcatheter bioprosthetic aortic valve placed within a previously placed degenerated transcatheter aortic valve, which was implanted in a degenerated surgical bioprosthetic aortic valve. The procedure was performed using a percutaneous cardiopulmonary bypass with TandemLife for hemodynamic support.

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High-pressure balloon fracturing of small dysfunctional Mitroflow bioprostheses facilitates transcatheter aortic valve-in-valve implantation

Abstract: Initial experience with transcatheter BF-VIV suggests that this method is feasible and safe, and that it improves aortic valve haemodynamics and clinical functional capacity. BF-VIV is a promising alternative to repeat surgery in patients with small failing Mitroflow bioprostheses.

Cited by 47 publications

References 10 publications

“Expanding the frame” for valve‐in‐valve therapy in small bioprostheses: Encouraging signs for the road ahead

“Expanding the frame” for valve‐in‐valve therapy in small bioprostheses: Encouraging signs for the road ahead

Bioprosthetic Valve Fracture During Valve-in-valve TAVR: Bench to Bedside

Valve-in-Valve-in-Valve: Degenerated Transcatheter Heart Valve within Degenerated Surgical Bioprosthetic Aortic Valve Treated with Second Transcatheter Heart Valve

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