Transcatheter aortic valve-in-valve implantation in degenerative rapid deployment bioprostheses

Landes, Uri; Dvir, Danny; Schoels, Wolfgang; Tron, C.; Ensminger, Stephan; Simonato, Matheus; Schäfer, Ulrich; Bunc, Matjaž; Aldea, Gabriel S.; Cerillo, Alfredo Giuseppe; Windecker, Stephan; Marzocchi, Antonío; Andreas, Martin; Amabile, Nicolas; Webb, John G.; Kornowski, Ran

doi:10.4244/eij-d-18-00752

Cited by 29 publications

(27 citation statements)

References 24 publications

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“…In order to reduce the incidence of PVR, we were cautious and rather reluctant to implant this bioprosthesis in patients with extensive calcifications of the root and rigid sinuses or true bicuspid aortic valves (Sievers type 0). The rate of structural valve degeneration was very low, and RD valves are an ideal target for ViV procedures (16,17).…”

Section: Discussionmentioning

confidence: 99%

Outcome of rapid deployment aortic valves: long-term experience after 700 implants

Coti

Haberl

Scherzer

et al. 2020

Ann Cardiothorac Surg

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Background: The Edwards Intuity Valve System is a bioprosthesis with a balloon-expandable stent frame which enables rapid-deployment (RD). We aimed to analyze our single-center long-term experience with a follow-up until 9 years after aortic valve replacement (AVR) with this bioprosthesis. Methods: Between May 2010 and May 2019, 700 consecutive patients with severe aortic stenosis or combined aortic valve disease, implanted with a RD valve at our institution, were included in a prospective database. Median follow-up was 19 months and the total accumulated follow-up was 2,140 patient-years. Pre-operative characteristics, operative parameters, survival rates, valve-related adverse events and valve hemodynamics were assessed. Results: Mean age was 74±8 years, 45% female. Concomitant procedures were performed in 339 (48.4%) patients. In case of isolated AVR (361/700), a minimally invasive surgical (MIS) approach was conducted in 283 patients (78.4%). Cardio-pulmonary bypass (CPB) and cross-clamp times for isolated AVR were 107.7±28.2 and 73.8±21.3 minutes for MIS approaches and 92.8±28.8 and 57.5±20.6 minutes for full sternotomy (P<0.001), respectively. Mean gradients at discharge, 1, 3 and 5 years were 13±5, 11±4, 12±5 and 13±8 mmHg. New early pacemaker implantation was required in 8.9% of patients. Re-intervention or reoperation with valve explantation for structural degeneration, non-structural dysfunction or endocarditis, occurred in 21 cases (3%). Thirty-day mortality was 0.7% (5/700) and overall survival at 1, 3 and 5 years was 98%, 91% and 76%. Conclusions: We report excellent long-term results in this updated single center experience for RD aortic valves regarding durability, safety and hemodynamic performance.

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Section: Discussionmentioning

confidence: 99%

Outcome of rapid deployment aortic valves: long-term experience after 700 implants

Coti

Haberl

Scherzer

et al. 2020

Ann Cardiothorac Surg

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“…Despite their excellent hemodynamic long-term outcome, above-mentioned positive features, and the recapture ability of some devices, they are used in less than one-third of VIV in latest-generation SAVs. 7 Unfortunately, with some self-expanding THVs, accessing the coronary arteries after VIV can be difficult. However, due to a sophisticated closed-cell, diamond-shaped configuration of the nitinol stent frame with a variable cell size distribution, the Allegra THV allows easy access for potential percutaneous coronary intervention at a later stage.…”

Section: Discussionmentioning

confidence: 99%

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2021

Thorac Cardiovasc Surg Rep

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“…With the four cases reported here [including a previous report of one case (16)], a total number of 26 cases have been reported, in which a TAVR procedure was performed in failed SV and RDV. In addition, there is a report of 30 cases by Landes et al (22), as part of the VIVID International Registry (22), which may represent some of the single case reports, published in the literature overview given in Table 2. In the majority of cases, TAVR was performed in sutureless Perceval valves (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)20,21).…”

Section: Discussionmentioning

confidence: 99%

A series of four transcatheter aortic valve replacement in failed Perceval valves

Misfeld

Abdel‐Wahab

Thiele

et al. 2020

Ann Cardiothorac Surg

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In recent years, sutureless valves (SV) and rapid deployment valves (RDVs) have become interesting aortic valve substitutes, especially in minimally invasive aortic valve surgery, as they reduce cardio-pulmonary bypass and cross-clamp times. There are two valve types available, the sutureless Perceval and the rapid deployment Intuity valve prosthesis. When these valves fail, besides surgical re-replacement, the valvein-valve concept has been reported in a small series of case reports. Our own experience includes four cases of failed Perceval valves, in which a balloon-expandable transcatheter valve was implanted in three patients, and a self-expanding transcatheter valve was implanted in a fourth patient. Here, we present these four cases with a focus on the specific valve design of the Perceval valve, as well as on important technical aspects. All cases were performed successfully with clinical improvement. Transcatheter aortic valve replacement (TAVR) as a valve-in-valve concept seems to be a valuable option in selected patients with failed sutureless or RDVs.

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Transcatheter aortic valve-in-valve implantation in degenerative rapid deployment bioprostheses

Cited by 29 publications

References 24 publications

Outcome of rapid deployment aortic valves: long-term experience after 700 implants

Outcome of rapid deployment aortic valves: long-term experience after 700 implants

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A series of four transcatheter aortic valve replacement in failed Perceval valves

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