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Review
. 2021 Sep;10(5):564-570.
doi: 10.21037/acs-2021-tviv-25.

Bioprosthetic valve fracture: a practical guide

Keith B Allen  1 , Adnan K Chhatriwalla  1 , John T Saxon  1 , Chetan P Huded  1 , Janarthanan Sathananthan  2 , Tom C Nguyen  3 , Brian Whisenant  4 , John G Webb  2
Affiliations
Review

Bioprosthetic valve fracture: a practical guide

Keith B Allen et al. Ann Cardiothorac Surg. 2021 Sep.

Abstract

Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement. VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively. This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.

Keywords: Surgical aortic valve replacement; bioprosthetic valve fracture (BVF); replacement; transcatheter aortic valve; valve in valve.

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Conflict of interest statement

Conflicts of Interest: KBA: Edwards Lifesciences: Research Support, Proctor, Speakers Bureau; Medtronic: Research Support, Speakers Bureau; Abbott: Research Support, Consulting; Boston Scientific: Consulting; AKC: Abbott Vascular: Speakers Bureau; Boston Scientific: Research support, consulting; Edwards Lifesciences: Proctor, Speakers Bureau; Medtronic Inc: Proctor, Speakers Bureau. JTS: Medtronic Inc: Proctor. CPH: none. JS: Edwards Lifesciences and Medtronic: Consulting; TCN: Edwards Lifesciences: Consulting. BW: Edwards Lifesciences: Consulting. JGW: Consulting for Edwards Lifesciences, Abbott, Boston Scientific.

Figures

Video
Video
Bioprosthetic valve fracture: a practical guide.
See this image and copyright information in PMC

References

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