Transcatheter valve–in–valve aortic valve replacement with bioprosthetic valve Fracture/Stretching technique in a degenerated mitroflow valve

Singh, Maninder; Reitknecht, Felice; Rogers, Guy; Kaluski, Edo

doi:10.1016/j.jccase.2020.01.006

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Importantly, our case is one of the first in the literature to show that BVF of a Mitroflow 19 mm surgical aortic bioprosthesis and ViV TAVI with markedly oversized self-expandable transcatheter valve is feasible. 13 …”

Section: Discussionmentioning

confidence: 99%

Valve-in-valve transcatheter aortic valve implantation with fracturing of a failed small surgical aortic bioprosthesis: a case report

Bunc

Čerček

Podlesnikar

et al. 2020

European Heart Journal - Case Reports

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Background Failure of a small surgical aortic bioprosthesis represents a challenging clinical scenario with valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) often resulting in patient-prosthesis mismatch. Bioprosthetic valve fracture (BVF) performed as a part of the ViV TAVI has recently emerged as an alternative approach with certain types of surgical bioprostheses. Case summary An 81-year-old woman with a history of three surgical aortic valve procedures presented with heart failure. Aortic bioprosthesis degeneration with severe stenosis and moderate regurgitation was found. The patient was deemed a high-risk surgical candidate and the heart team decided that ViV TAVI was the preferred treatment option. Due to the very small 19 mm stented surgical aortic bioprosthesis Mitroflow 19 mm (Sorin Group, Italy) we decided to perform BVF as a part of ViV TAVI to prevent patient-prosthesis mismatch. Since this was the first BVF procedure in our centre, an ex vivo BVF of the same kind of bioprosthetic valve was performed first. Subsequently, successful BVF with implantation of Evolut R 23 mm (Medtronic, USA) self-expandable transcatheter valve was performed. Excellent haemodynamic result was achieved and no periprocedural complications were present. The patient had an immediate major improvement in clinical status and remains asymptomatic after 6 months. Discussion Bioprosthetic valve fracture together with ViV TAVI is a safe and effective emerging technique for treatment of small surgical aortic bioprosthesis failure. Bioprosthetic valve fracture allows marked oversizing of implanted self-expandable transcatheter aortic valves, leading to excellent haemodynamic and clinical results. An ex vivo BVF can serve as an important preparatory step when introducing the new method.

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Section: Discussionmentioning

confidence: 99%