Surgical aortic valve replacement after percutaneous aortic valve implantation: What have we learned?

Abstract

Percutaneous heart valve implantation, which provides a larger surface area than balloon valvotomy, can be offered to patients with cardiogenic shock and severe comorbidities to improve their hemodynamic state and reduce their surgical risk.

Outcome after valve surgery in octogenarians and efficacy of early mobilization with early cardiac rehabilitation

“…6,8 On the other hand, Lizler et al reported that emergent surgical AVR was performed uneventfully after failed TAVI. 11 Giammarco et al showed that the EuroScore appears to be an invalid model as an absolute or relative risk predictor for isolated AVR, and its use in selecting candidates for TAVI should be carefully weighed. 10 Currently, the outcome of conventional AVR has improved continuously in octogenarians, and several groups have shown that cardiac surgery can be performed in octogenarian patients with acceptable mortality, good long-term results, and a good quality of life.…”

“…Although transcatheter aortic valve implantation (TAVI) for severe aortic stenosis has begun to be introduced lately to patients with excessive risk and advanced age, [6][7][8] surgery is an effective therapeutic option for selected symptomatic elderly patients with good long-term survival and improved functional class. 9 It is crucial for the selection of candidates to undergo the evolving TAVI procedure 10,11 ; however, operative complications and hospital mortality have not been thoroughly investigated in unselected octogenarians undergoing valve surgery.…”

Delayed dislocation of a transapically implanted aortic bioprosthesis

“…that might contraindicate this procedure. Although mounting experience will no doubt provide the answers to some of these questions, others will need to be addressed in randomised studies [4].…”

An Engineering Review of Transcatheter Aortic Valve Technologies

“…Although rarely, the ESV has also been a victim of asymmetric expansion in severely calcific valves, resulting in aortic regurgitation and subsequent surgical valve replacement. 22 Additionally the frame could be subjected to complex out of plane forces from the orifice due its forced shape, and thus in the long term may be at the risk of dislodgement or disorientation as recently shown in a clinical report by Maroto et al 23 and an ex vivo cadaver study by Bombien et al 4 Finite element studies on calcific aortic valve reconstructions from MRI or 4D-CT can be performed to understand the mechanics of the calcified native leaflets with simulated TAVI and is an active research topic in our institution.…”