Transcatheter aortic valve‐in‐valve treatment of degenerative stentless supra‐annular Freedom Solo valves: A single centre experience

Abstract

ViV-TAVI in stentless Freedom Solo valves is high risk. The risk of coronary occlusion is high. The smallest possible prosthesis (1:1 sizing) should be used, and strategies to protect the coronary vessels must be considered. © 2016 Wiley Periodicals, Inc.

Transcatheter aortic valve‐in‐valve implantation in failed stentless bioprostheses

“…Duncan et al provided reassuring data on the performance of ViV‐TAVI in a group of 22 patients with homografts mostly and Bapat et al described rather favourable results in 10 patients with failed stenltess valves treated only with the use of balloon‐expandable prostheses. In contrast, small case series of ViV‐TAVI in specifically designed supra‐anullar surgical prosthesis (Freedom Solo) showed high risk of coronary occlusion . The current study complements the above‐mentioned results in various aspects.…”

Neo Left Main Channel Creation Using Double Stenting Alongside a Sapien 3 Aortic Valve Bioprosthesis for Left Main Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement: A Case Report With Review of Literature

“…Mechanical obstruction of LM coronary ostium is more common than right ostium, and acute hemodynamic compromise is reported more often than delayed presentation following TAVR. 3 , 13 - 19 This case highlights the importance of management of coronary obstruction in the setting of VIV utilizing Edwards Sapien 3 THV for the failed Mitroflow bioprosthesis with the insertion of stents between the surgical valve leaflets and aorta creating a channel (“neo left main”) such that the flow through coronary ostium into the coronary system can be regained.…”

“…Coronary obstruction following VIV TAVR procedure is uncommon with an overall reported incidence of ≤3.5% across different VIV registries. 3 , 11 , 12 This in addition to the data from case reports and case series have documented instances of coronary obstruction with the use of various transcatheter heart valves (THVs) on stented or stentless surgical bioprosthesis valves 3 , 11 - 17 ( Table 1 ). However, no data exist on incidence or management of coronary obstruction in patients undergoing Edwards Sapien 3 THV for the failed Mitroflow surgical bioprosthesis.…”

Successful Reoperation in 3 Cases of Failed Sorin Freedom Stentless Aortic Valve Using the LivaNova Perceval Sutureless Prosthesis

“…The global VIV registry reported a 50% risk of coronary obstruction associated with TAVI-VIV in degenerated SPF-Solo valves, much higher when compared to the 3.5% risk reported for overall VIV procedures. 12 Three-dimensional transesophageal echocardiography and multidetector CT scan maybe helpful in the assessment of the aortic root anatomy and of the prosthetic cusp height in relation to the coronary ostia. Based on these evaluations, patients with a failed SPF valve having poorly dilated aortic sinuses and coronary arteries originating very close to the aortic valve annulus should be considered at very high risk for a TAVI-VIV procedure.…”