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. 2015 Mar;4(2):214-7.
doi: 10.3978/j.issn.2225-319X.2014.11.12.

In the era of the valve-in-valve: is transcatheter aortic valve implantation (TAVI) in sutureless valves feasible?

Marco Di Eusanio  1 , Francesco Saia  1 , Giovanni Pellicciari  1 , Kevin Phan  1 , Marinella Ferlito  1 , Gianni Dall'Ara  1 , Roberto Di Bartolomeo  1 , Antonio Marzocchi  1
Affiliations

In the era of the valve-in-valve: is transcatheter aortic valve implantation (TAVI) in sutureless valves feasible?

Marco Di Eusanio et al. Ann Cardiothorac Surg. 2015 Mar.

Abstract

Sutureless aortic valve implantation has emerged as an innovative alternative for treatment of aortic stenosis. By avoiding the placement of sutures, this approach aims to improve surgical outcomes by facilitating less traumatic minimally invasive approaches and reducing cross-clamp and cardiopulmonary bypass duration. However, the absence of sutures may have detrimental effects after sutureless interventions, including paravalvular leakages, valve dislocation, and stent-infolding. Transcatheter aortic valve-in-valve implantation (A-ViV) is emerging as a valuable procedure in patients with dysfunctioning biological aortic valves who are deemed inoperable with conventional surgery. Here we present the first-in-man case of trans-femoral implant of a balloon expandable aortic valve in a leaking sutureless self-expandable valve.

Keywords: Sutureless; aortic valve; minimally invasive; transcatheter; transcatheter aortic valve implantation (TAVI).

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Figures

Figure 1
Figure 1
Trans-thoracic echocardiography after the sutureless aortic valve replacement: (A) parasternal long-axis view with color Doppler showing severe aortic regurgitation; (B) continuous wave Doppler showing the trans-valvular gradient and the aortic regurgitation flow.
Figure 2
Figure 2
Angiography after sutureless aortic valve replacement showing (A) the Sorin Perceval S stent infolding at the non-coronary annulus; and (B) a severe valvular leakage.
Figure 3
Figure 3
Computed tomography after sutureless aortic valve replacement showing (A and B) the Sorin Perceval S stent infolding at the non-coronary annulus. NCS, non-coronary-sinus.
Video 1
Video 1
Trans-femoral Edwards Sapien XT 23 mm deployment in the sutureless Sorin Perceval S (size M).
Video 2
Video 2
Post deployment angiography showing full expansion of the sutureless Sorin Perceval S (size M) and a mild paravalvular leakage.
Figure 4
Figure 4
Trans-thoracic echocardiography after the valve-in-valve procedure showing (A) no residual aortic valve leakage; and (B) normal pressure gradients across the valve.
See this image and copyright information in PMC

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