Transcatheter Valve-in-Valve: A Cautionary Tale

Transcatheter aortic valve replacement (TAVR) by valve-in-valve (VIV) implantation is an alternative treatment for high-risk patients with a degenerating aortic bioprosthesis. We present a case of transapical TAVR VIV with a 29-mm Edwards SAPIEN XT (ESV) (Edwards Lifesciences, Irvine, CA) into a 29-...

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Veröffentlicht in:	The Annals of thoracic surgery 2016-09, Vol.102 (3), p.e211-e213
Hauptverfasser:	Luc, Jessica G.Y, Shanks, Miriam, MD, PhD, Tyrrell, Benjamin D., MD, Welsh, Robert C., MD, Butler, Craig R., MD, MS, Meyer, Steven R., MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged, 80 and over Aortic Valve Stenosis - complications Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Bioprosthesis Cardiothoracic Surgery Coronary Artery Bypass - methods Coronary Stenosis - complications Coronary Stenosis - diagnostic imaging Coronary Stenosis - surgery Echocardiography, Transesophageal - methods Follow-Up Studies Humans Intraoperative Complications - diagnostic imaging Intraoperative Complications - surgery Magnetic Resonance Imaging, Cine - methods Male Risk Assessment Severity of Illness Index Surgery Thoracotomy - methods Transcatheter Aortic Valve Replacement - methods Treatment Outcome
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Zusammenfassung:	Transcatheter aortic valve replacement (TAVR) by valve-in-valve (VIV) implantation is an alternative treatment for high-risk patients with a degenerating aortic bioprosthesis. We present a case of transapical TAVR VIV with a 29-mm Edwards SAPIEN XT (ESV) (Edwards Lifesciences, Irvine, CA) into a 29-mm Medtronic Freestyle stentless bioprosthesis (Medtronic Inc, Minneapolis, MN) in which unanticipated dilatation of the Freestyle bioprosthesis resulted in intraprocedural embolization of the TAVR valve, necessitating urgent conversion to a conventional surgical aortic valve replacement (AVR). Our experience suggests that TAVR VIV with the 29-mm ESV in the setting of a degenerated 29-mm Freestyle stentless bioprosthesis must be undertaken with caution.
ISSN:	0003-4975 1552-6259
DOI:	10.1016/j.athoracsur.2016.01.045