Transcatheter Aortic Valve Implantation for Failing Surgical Aortic Bioprosthetic Valve

Piazza, Nicolò; Bleiziffer, Sabine; Brockmann, Gernot; Hendrick, Ruge; Deutsch, Marcus-André; Opitz, A; Mazzitelli, Domenico; Tassani-Prell, Peter; Schreiber, Christian; Lange, Rüdiger

doi:10.1016/j.jcin.2011.05.007

Cited by 130 publications

(94 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The current study has demonstrated that ViV in stentless surgical bioprosthetic valve is feasible and safe with comparable clinical outcomes as in stented surgical bioprosthetic valve. Hemodynamics of ViV in the stentless group were superior with a larger effective orifice area Center series of 20 aortic valve patients with a 90% procedural success rate, 12 Our study has demonstrated comparable clinical outcomes of ViV in stentless group as compared to stented group. In the Global Valve-in-Valve Registry, high post-procedural gradients were common at 28%.…”

Section: Discussionsupporting

confidence: 51%

A comparison of valve‐in‐valve transcatheter aortic valve replacement in failed stentless versus stented surgical bioprosthetic aortic valves

Choi

Cheng

Malaver

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives The objectives of this study were to compare short‐ and intermediate‐term clinical outcomes, procedural complications, TAVR prosthesis hemodynamics, and paravalvular leak (PVL) in stentless and stented groups. Background Valve‐in‐valve (ViV) transcatheter aortic valve replacement (TAVR) is an alternative to surgical redo for bioprosthetic valve failure. There have been limited data on ViV in stentless surgical valves. Methods We retrospectively analyzed 40 patients who underwent ViV TAVR in prior surgical bioprosthetic valves at Wake Forest Baptist Medical Center from October 2014 to September 2017. Eighty percent (32/40) ViV TAVRs were in stentless, while 20% (8/40) were in stented bioprosthetic valves. Results The primary mode of bioprosthetic valve failure for ViV implantation in the stentless group was aortic insufficiency (78%, 25/32), while in the stented group was aortic stenosis (75%, 6/8). The ViV procedure success was 96.9% (31/32) in stentless group and 100% in stented group (8/8). There were no significant differences in all‐cause mortality at 30 days between stentless and stented groups (6.9%, 2/31 versus 0%, 0/8, P = 0.33) and at 1 year (0%, 0/25 versus 0%, 0/5). In the stentless group, 34.4% (11/32) required a second valve compared to the stented group of 0% (0/8). There was a significant difference in the mean aortic gradient at 30‐day follow‐up (12.33 ± 6.33 mmHg and 22.63 ± 8.45 mmHg in stentless and stented groups, P < 0.05) and at 6‐month follow‐up (9.75 ± 5.07 mmHg and 24.00 ± 11.28 mmHg, P < 0.05), respectively. Conclusions ViV in the stentless bioprosthetic aortic valve has excellent procedural success and intermediate‐term results. Our study shows promising data that may support the application of TAVR in stentless surgical aortic valve. However, further and larger studies need to further validate our single center's experience.

show abstract

Section: Discussionsupporting

confidence: 51%

A comparison of valve‐in‐valve transcatheter aortic valve replacement in failed stentless versus stented surgical bioprosthetic aortic valves

Choi

Cheng

Malaver

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Transcatheter aortic valve‐in‐valve (VIV) implantation in high‐risk patients with degenerative surgical bioprosthetic aortic valves is a novel application of transcatheter aortic valve replacement (TAVR) technology . Numerous case series, case reports and recently, the Global Valve‐in‐Valve registry have reported the safety and efficacy of transcatheter VIV procedure for degenerative bioprosthetic surgical aortic valves.…”

Section: Introductionmentioning

confidence: 99%

Pre‐emptive positioning of a coronary stent in the left anterior descending artery for left main protection: A prerequisite for transcatheter aortic valve‐in‐valve implantation for failing stentless bioprostheses?

Chakravarty

Jilaihawi

Nakamura

et al. 2013

Cathet Cardio Intervent

View full text Add to dashboard Cite

Transcatheter aortic valve-in-valve (VIV) implantation in high-risk patients with degenerative surgical bioprosthetic aortic valves is a novel application of transcatheter aortic valve replacement technology. Although transcatheter aortic VIV procedure is clinically effective in most patients, it is a more demanding procedure in terms of the technical aspects of procedural planning. VIV carries a higher risk of coronary occlusion which is associated with a higher rate of in-hospital mortality. We hereby report a technique of pre-emptive left main (LM) protection, by positioning a coronary stent in the proximal left anterior descending artery prior to VIV implantation. The patient treated was considered to be at an increased risk of LM occlusion as a result of the procedure. The technique was performed in anticipation of emergent bailout stenting of the LM. As predicted, the LM occluded during the procedure and LM protection facilitated the safe and effective treatment of an otherwise life-threatening procedure.

show abstract

“…The frame of most bioprostheses can facilitate THV positioning. Smaller diameter valves (19 mm) will not facilitate the delivery of the currently available valves, but in patients with larger valves, a transcatheter valve-in-valve procedure may be a good option [41–43]. A registry is currently being conducted of all valve-in-valve cases and is sponsored by Edwards Lifesciences.…”

Section: Future Directionsmentioning

confidence: 99%

The Edwards SAPIEN Transcatheter Heart Valve for Calcific Aortic Stenosis: A Review of the Valve, Procedure, and Current Literature

2012

View full text Add to dashboard Cite

The Edwards SAPIEN™ transcatheter heart valve (Edwards Lifesciences LLC, Irvine, CA, USA) is approved by the US Food and drug administration for use in the aortic position in patients with severe aortic stenosis who are not surgical candidates. This approval was backed by data from the Placement of AoRTic TraNscathetER Valve (PARTNER) I clinical trial, which showed the valve to be superior to standard medical therapy in high-risk nonoperative patients in cohort B of the trial. Although insertion of the valve is considered to be very safe, stroke, major vascular complications, and conduction abnormalities are the most frequent procedural complications. A dedicated team of physicians trained in structural cardiac interventions, including two interventional cardiologists, an echocardiographer, and a cardiac surgeon, are involved in every case. Improvements in valve design and streamlining of the delivery system, as well as favorable long-term outcomes, will hopefully pave the way for wider patient use in the future.

show abstract

Transcatheter Aortic Valve Implantation for Failing Surgical Aortic Bioprosthetic Valve

Abstract: TAV-in-SAV implantation is a safe and feasible treatment for high-risk patients with failing aortic bioprosthetic valves and should be considered as part of the armamentarium in the treatment of aortic bioprosthetic valve failure.

Cited by 130 publications

References 23 publications

A comparison of valve‐in‐valve transcatheter aortic valve replacement in failed stentless versus stented surgical bioprosthetic aortic valves

A comparison of valve‐in‐valve transcatheter aortic valve replacement in failed stentless versus stented surgical bioprosthetic aortic valves

Pre‐emptive positioning of a coronary stent in the left anterior descending artery for left main protection: A prerequisite for transcatheter aortic valve‐in‐valve implantation for failing stentless bioprostheses?

The Edwards SAPIEN Transcatheter Heart Valve for Calcific Aortic Stenosis: A Review of the Valve, Procedure, and Current Literature

Contact Info

Product

Resources

About