Transcatheter aortic valve replacement after valve‐sparing aortic root surgery

Tugulan, Carmen; Bedi, Ryan; Jacks, Danielle; Parrino, E.; Spindel, Stephen M.

doi:10.1111/jocs.15410

Cited by 3 publications

(3 citation statements)

References 6 publications

(11 reference statements)

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“…Similar to Tay et al, 5 Favero et al, in 2017 presented a patient who underwent TAVI in a patient with a previous aortic valve-sparing operation according to David. 2 Similar cases were presented by Patel et al 6 and Tugulan et al 7 All the aforementioned cases were after the treatment of anuloaortic ectasia; however, our case differed as the initial procedure was during aortic dissection surgery in which the presence of double lumen at the arch vessels and the descending aorta made it more complicating for conventional surgical aortic valve replacement from the points of cannulation and perfusion strategies as well.…”

Section: Discussionsupporting

confidence: 71%

Transcatheter aortic valve implantation for pure aortic insufficiency in a patient following David‐type aortic valve‐sparing root replacement after aortic dissection—A successful off‐label procedure

Oztas,

Ozdemir,

Bauernschmitt

et al. 2024

Cathet Cardio Intervent

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Transcatheter aortic valve implantation (TAVI) has traditionally been indicated for the treatment of aortic stenosis. However, in this case report, we describe a successful TAVI procedure in a 46‐year‐old male patient who had previously undergone David aortic valve‐sparing aortic root replacement for type 1 aortic dissection. The patient presented with aortic valve insufficiency 4 years after the initial surgery and was subsequently treated with a 34 mm Medtronic CoreValve Evolut R prosthesis via TAVI. This case highlights the feasibility of TAVI as a viable treatment option for postoperative aortic valve insufficiency in patients with prior ascending aortic or aortic arch surgery.

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Section: Discussionsupporting

confidence: 71%

Transcatheter aortic valve implantation for pure aortic insufficiency in a patient following David‐type aortic valve‐sparing root replacement after aortic dissection—A successful off‐label procedure

Oztas,

Ozdemir,

Bauernschmitt

et al. 2024

Cathet Cardio Intervent

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“…After removing duplicates, 639 studies were screened, and 32 full‐text articles were assessed for eligibility. Ultimately, 31 articles 12,17–46 including a total of 86 patients met the inclusion criteria. These studies were published between 2009 and 2023, with sample sizes ranging from 1 to 27 patients, Table 1.…”

Section: Resultsmentioning

confidence: 99%

Transcatheter valve‐in‐valve interventions after aortic root replacement: A systematic review

Baudo,

Cuko,

Ternacle

et al. 2024

Cathet Cardio Intervent

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Structural valve deterioration after aortic root replacement (ARR) surgery may be treated by transcatheter valve‐in‐valve (ViV‐TAVI) intervention. However, several technical challenges and outcomes are not well described. The aim of the present review was to analyze the outcomes of ViV‐TAVI in deteriorated ARR. This review included studies reporting any form of transcatheter valvular intervention in patients with a previous ARR. All forms of ARR were considered, as long as the entire root was replaced. Pubmed, ScienceDirect, SciELO, DOAJ, and Cochrane library databases were searched until September 2023. Overall, 86 patients were included from 31 articles that met our inclusion criteria out of 741 potentially eligible studies. In the entire population, the mean time from ARR to reintervention was 11.0 years (range: 0.33–22). The most frequently performed techniques/grafts for ARR was homograft (67.4%) and the main indication for intervention was aortic regurgitation (69.7%). Twenty‐three articles reported no postoperative complications. Six (7.0%) patients required permanent pacemaker implantation (PPI) after the ViV‐TAVI procedure, and 4 (4.7%) patients had a second ViV‐TAVI implant. There were three device migrations (3.5%) and 1 stroke (1.2%). Patients with previous ARR present a high surgical risk. ViV‐TAVI can be considered in selected patients, despite unique technical challenges that need to be carefully addressed according to the characteristics of the previous surgery and on computed tomography analysis.

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“…2 In such cases, a traditional reoperation may represent a high-risk procedure, especially when a failure occurs early. The interesting case reported by Tugulan et al 3 in the Journal of Cardiac Surgery, describing the successful use of TAVR in a patient presenting with severe AI, 4 months after a valve-sparing procedure, seems to contradict this statement.…”

Section: Transcatheter Aortic Valve Replacement After Valve-sparing A...mentioning

confidence: 98%