Series of transcatheter valve‐in‐valve implantations in high‐risk patients with degenerated bioprostheses in aortic and mitral position

Seiffert, Moritz; Franzen, Olaf; Conradi, Lenard; Baldus, Stephan; Schirmer, Johannes; Meinertz, Thomas; Reichenspurner, Hermann; Treede, Hendrik

doi:10.1002/ccd.22618

Cited by 101 publications

(64 citation statements)

References 41 publications

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“…To date, several cases of transcatheter mitral valve-in-valve implantations have been reported, but only 1 case of transapical valve-in-ring implantation has been reported. [1][2][3][4] The present report confirms the feasibility and effectiveness of such transcatheter mitral interventions and the ability of the Sapien valve to be sewed in an asymmetrical annuloplasty ring as previously observed 1 and demonstrated here. Questions about valve-in-ring implantation concern the size, the deformability, and the asymmetrical geometry of the ring.…”

Section: Discussionsupporting

confidence: 87%

“…Another unsuccessful attempt through a transatrial route was performed, and all other cases were achieved through the transapical route. 2,3 The transseptal route has several advantages, including being less invasive, carrying minimal risk of vascular complications, and being compatible with local anesthesia. However, several precautions should be considered: (1) Expertise in transseptal catheterization is required, (2) the distance between the septal puncture site and the mitral valve must be sufficient to allow complete deployment of the balloon in the left atrium (a high and posterior transseptal puncture site may be considered in this particular context), and (3) the positioning may be easier and more stable with the transapical route.…”

Section: Discussionmentioning

confidence: 99%

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Transseptal Implantation of a Transcatheter Heart Valve in a Mitral Annuloplasty Ring to Treat Mitral Repair Failure

Himbert

Brochet

Radu

et al. 2011

Circ: Cardiovascular Interventions

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A 56-year-old woman was admitted for recurrent, refractory congestive heart failure. When she was aged 17 years, she had a Hodgkin lymphoma treated by chest radiation. She then developed postradiation heart disease, which required surgery in 2004, combining mitral valve repair using a Physio semirigid ring sized 28 mm (Edwards Lifesciences Inc; Irvine, CA) and tricuspid annuloplasty. In March 2009, the patient experienced recurrent congestive heart failure due to mitral valve stenosis. Percutaneous mitral commissurotomy achieved transient symptom relief, but her clinical status severely worsened in the past year.On admission, the patient was in New York Heart Association class IV heart failure. Physical examination showed worrying skin sequelae of chest radiation and severe congestive heart failure. Echocardiography demonstrated severe mitral valve stenosis (mean gradient, 11 mm Hg), regurgitation (grade 3ϩ), dilatation of the right atrium and ventricle, moderate tricuspid regurgitation, and estimated systolic pulmonary artery pressure Ͼ60 mm Hg (Move 1). On multislice CT, the anteroposterior diameter of the mitral ring was calculated at 16 mm and the intercommissural diameter at 27 mm.Because repeated surgery carried a prohibitive risk, a transcatheter option was considered. Because of the cutaneous lesions and postradiation cardiomyopathy, the transapical approach was deemed inadequate; thus, it was decided to intervene through the right femoral vein and a transseptal route. After transseptal catheterization and septal dilation with a 10-mm balloon, crossing the mitral valve with a balloon wedge pressure catheter, a J preshaped 0.035 ExtraStiff wire was placed at the apex of the left ventricle. A 26-mm Edwards Sapien XT transcatheter heart valve was mounted on a Novaflex catheter (Edwards Lifesciences) and advanced to the mitral ring. The prosthesis was then deployed under rapid pacing (Figure 1, Video 2). Postoperatively, the patient's functional condition rapidly improved. Echocardiographic examination showed a trivial periprosthetic leak and a mean transmitral gradient of 8 mm Hg, a 13-mm Hg gradient was observed in the left ventricular outflow tract, and systolic pulmonary artery pressure dropped to 45 mm Hg

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Transseptal Implantation of a Transcatheter Heart Valve in a Mitral Annuloplasty Ring to Treat Mitral Repair Failure

Himbert

Brochet

Radu

et al. 2011

Circ: Cardiovascular Interventions

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“…8 -10 In recent years, several reports have suggested that the off-label use of TAVR within failed surgically inserted bioprosthetic valves (valve-in-valve [VIV]) is technically feasible. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] However, all previous reports evaluating the VIV approach have included a small number of cases and are limited in providing measures of efficacy and safety. High postprocedural gradients and several potentially life-threatening complications, such as ostial coronary obstruction, were only reported anecdotally, and there was no comparison between different devices possibly applicable for VIV.…”

Section: Editorial See P 2280 Clinical Perspective On P 2344mentioning

confidence: 99%

Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves

et al. 2012

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Background-Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry. Key Words: bioprosthesis Ⅲ transcatheter aortic valve implantation Ⅲ valve-in-valve M ore than 200 000 surgical aortic valve replacements (SAVR) are performed annually worldwide, with a substantial shift toward the use of bioprostheses rather than mechanical valves. 1 Bioprostheses have limited durability, and most are expected to degenerate and eventually fail within 10 to 20 years. 2-4 As a result, it is estimated that in the subsequent few years, many patients will suffer from failed surgical bioprosthetic valves. Reoperation, the standard of care for these patients, is occasionally a high-risk procedure that carries significant mortality and morbidity risks, especially because many of these patients are elderly and have numerous comorbidities. [5][6][7] Continuing medical education (CME) credit is available for this article. Go to http://cme.ahajournals.org to take the quiz. Methods and Results-The

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“…7,[20][21][22] A Canadian registry (n=24) was soon followed by an Italian registry (n=25), 2 German registries (n=20, n=47), and numerous other small case series and isolated case reports documenting favorable outcomes. 7,8,[23][24][25][26][27][28][29][30][31] The Global Valve-in-Valve Registry, an industry-independent collaboration, was introduced in 2010 to collate this increasing but widely distributed experience.…”

Section: The Vinv Procedures Clinical Experiencementioning

confidence: 99%

Transcatheter Aortic Valve Replacement for Bioprosthetic Aortic Valve Failure

2013

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Series of transcatheter valve‐in‐valve implantations in high‐risk patients with degenerated bioprostheses in aortic and mitral position

Cited by 101 publications

References 41 publications

Transseptal Implantation of a Transcatheter Heart Valve in a Mitral Annuloplasty Ring to Treat Mitral Repair Failure

Transseptal Implantation of a Transcatheter Heart Valve in a Mitral Annuloplasty Ring to Treat Mitral Repair Failure

Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves

Transcatheter Aortic Valve Replacement for Bioprosthetic Aortic Valve Failure

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