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Review
. 2018 Nov;10(Suppl 30):S3573-S3577.
doi: 10.21037/jtd.2018.05.66.

Transcatheter valve-in-valve implantation for degenerated surgical bioprostheses

Dale J Murdoch  1 , John G Webb  1
Affiliations
Review

Transcatheter valve-in-valve implantation for degenerated surgical bioprostheses

Dale J Murdoch et al. J Thorac Dis. 2018 Nov.

Abstract

Transcatheter valve-in-valve (VIV) procedures are less invasive than re-do open heart surgery, and have proven relatively safe and effective. In large multicentre registries morbidity and mortality risks are generally lower than with surgery, and improvement in quality of life can be profound. Outcomes continue to improve with advances in transcatheter heart valve (THV) technology, techniques, and expertise. However specific concerns remain; including residual stenosis, coronary obstruction, left ventricular outflow tract obstruction, and thrombosis. The unknown durability is a concern in patients with the potential for longevity. Transcatheter VIV procedures will likely increasingly be favoured over reoperation when bioprosthetic heart valves fail, particularly when surgical risks are high.

Keywords: Valve-in-valve (VIV); aortic valve; aortic valve replacement; transcatheter aortic valve replacement (TAVR).

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Conflict of interest statement

Conflicts of Interest: JG Webb: Consultant- Edwards Lifesciences. Another author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Medtronic CoreValve Evolut R (left) and Edwards SAPIEN 3 (right) THVs deployed within bioprosthetic aortic valves. THVs, transcatheter heart valves.
Figure 2
Figure 2
Recommended positioning of the SAPIEN 3 valve in the aortic position (left) and mitral position (right).
See this image and copyright information in PMC

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