Transcatheter aortic valve-in-valve implantation for early failure of sutureless aortic bioprosthesis

Sun, Xiaotian; Song, Zengqiang; Soffer, Daniel; Pirris, John

doi:10.1111/jocs.13567

Cited by 10 publications

(11 citation statements)

References 7 publications

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“…Dvir et al suggested that there is a greater risk of coronary obstruction in stentless valves, especially Sorin Freedom Solo valve, where the coronary obstruction occurs significantly more frequently than in the other stentless valves. Nevertheless, VIV TAVI has been successfully performed in sutureless valves . Although we did not use any form of coronary ostia protection during the procedure, no coronary obstruction was observed in our series regardless of the previously implanted bioprosthesis.…”

Section: Discussionmentioning

confidence: 75%

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Severe structural deterioration of small aortic bioprostheses treated with valve-in-valve transcatheter aortic valve implantation

et al. 2019

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Objectives The aim of this study was to evaluate outcomes of valve‐in‐valve transcatheter aortic valve implantation (VIV‐TAVI) in patients with degenerated small bioprostheses. Methods Outcomes of consecutive 27 high‐risk patients (logistic EuroSCORE 35.5 ± 18.5%) with a mean age of 81.0 ± 5.9 years who underwent VIV‐TAVI for degenerated small bioprostheses (19 mm‐11.1%; 20 mm‐11.1%; 21 mm‐77.8%) were analyzed. Medtronic CoreValve (n = 11) or CoreValve Evolut‐R prostheses (n = 16) were implanted. Follow‐up was 3.2 ± 2.0 years. Results Early mortality was 11.1%. One patient died intraoperatively due to left ventricle perforation, two others during the in‐hospital period as a result of sudden cardiac death and pulmonary embolism. VIV‐TAVI was completed in 26 cases (96.3%—success rate). Two patients required pacemaker implantation. Acute kidney injury occurred in two other patients. At discharge, mean transvalvular gradient was 19.2 ± 9.5 mmHg and in 25.9% of patients mean gradient exceeded 20 mmHg. Overall mortality was 25.9% and mortality from cardiac or unknown causes at 18.5%. Ninety percent of survivors were in New York Heart Association (NYHA) class I or II. Conclusions Transfemoral VIV‐TAVI in patients with small, degenerated bioprostheses appears to be a promising alternative to surgery. Although the vast majority of patients have significant improvement in their NYHA class, the rate of persistent, residual gradients is relatively high and will need to be followed closely with serial echocardiograms.

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Section: Discussionmentioning

confidence: 75%

“…Nevertheless, VIV TAVI has been successfully performed in sutureless valves. 18 Although we did not use any form of coronary ostia protection during the procedure, no coronary obstruction was observed in our series regardless of the previously implanted bioprosthesis.…”

Section: Long-term Follow-upmentioning

confidence: 69%

Severe structural deterioration of small aortic bioprostheses treated with valve-in-valve transcatheter aortic valve implantation

et al. 2019

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“…The most common described mechanism of failure was so-called "stent creep" wherein the valve framework bends inward thereby deforming the valve leading to an increased aortic valvular gradient which ultimately leads to valve failure [10]. There are a number of reports of ViV-TAVR repair of SPV failure due to stent creep [7][8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Early Structural Deterioration of a Sutureless Bioprosthetic Aortic Valve

et al. 2020

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Sutureless bioprosthetic valves such as the Sorin Perceval S valve (SPV) have been used in patients with aortic stenosis that require surgical aortic valve replacement (SAVR). These prostheses have been marketed on the basis of their rapid implantation techniques with avoidance of sutures and reduced aortic cross-clamp times. We report a case of an early failure of a SPV nearly 4 years after implantation in a 58-year-old woman who was low-risk. While the patient's symptoms initially improved with SAVR with a sutureless bioprosthetic valve, they progressively worsened as the valve degraded, and the leaflets became increasingly calcified and stenotic ultimately, requiring reoperative SAVR with a St. Jude mechanical valve. This case raises the issue of the lack of much-needed data describing the long-term durability and hemodynamic performance of these valves, particularly in a low-risk patient with excellent functional status. We hope to shed further insight into the lack of long-term studies on patients with SPV to assess their longevity and long-term effectiveness, as well as elucidation of possible prevention and monitoring of these potential complications. The use of newer generation prostheses, although attractive for their ease of implantation, potentially carries higher long-term risk due to shorter durability leading to reintervention to address valve deterioration. This is especially true in low-risk patients who are young and active. Cardiology and cardiothoracic surgery societies need to develop a universal registry with follow-up of all valves in order to track and study the durability of these valves, and to evaluate for incidence of known and potential complications.

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“…There is an increasing use of percutaneous cardiac valve placement either as primary therapy or for failing bioprosthetic valves . Percutaneous valves also have been implanted in adults with previous congenital cardiac surgical repairs .…”

Section: Introductionmentioning

confidence: 99%

“…There is an increasing use of percutaneous cardiac valve placement either as primary therapy or for failing bioprosthetic valves. 1 Percutaneous valves also have been implanted in adults with previous congenital cardiac surgical repairs. 2 A challenging patient subset are those with tricuspid or mitral annuloplasty rings, as these have very small "landing zones" for the percutaneous valves.…”

Section: Introductionmentioning

confidence: 99%

Treatment of tricuspid regurgitation and para-ring leak in tetralogy of Fallot with oversized SAPIEN 3 valve-in-ring implantation

et al. 2018

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A 40-year-old female with previously repaired tetralogy of Fallot had recurrent severe tricuspid regurgitation with a para-ring leak after annuloplasty ring placement. Because of multiple prior sternotomies and co-morbidities, she was not felt to be a surgical candidate. Percutaneous placement of an oversized SAPIEN 3 valve-in-ring in the tricuspid position successfully treated the regurgitation and para-ring leak.

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Transcatheter aortic valve-in-valve implantation for early failure of sutureless aortic bioprosthesis

Abstract: We report a case of early failure of a Perceval sutureless aortic bioprosthesis (LivaNova, London, UK) which was treated with a transcatheter valve-in-valve implantation with an Edwards 3 bioprosthesis (Edwards Lifesciences, Irvine, CA).

Cited by 10 publications

References 7 publications

Severe structural deterioration of small aortic bioprostheses treated with valve-in-valve transcatheter aortic valve implantation

Severe structural deterioration of small aortic bioprostheses treated with valve-in-valve transcatheter aortic valve implantation

Early Structural Deterioration of a Sutureless Bioprosthetic Aortic Valve

Treatment of tricuspid regurgitation and para-ring leak in tetralogy of Fallot with oversized SAPIEN 3 valve-in-ring implantation

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