Valve-in-valve implantation with a 23-mm balloon-expandable transcatheter heart valve for the treatment of a 19-mm stentless bioprosthesis severe aortic regurgitation using a strategy of “extreme” underfilling

2014 ◽  
Vol 84 (3) ◽  
pp. 503-508 ◽  
Author(s):  
Florent Chevalier ◽  
Jonathon Leipsic ◽  
Philippe Généreux
Keyword(s):  
Aortic Regurgitation ◽  
Heart Valve ◽  
Severe Aortic Regurgitation ◽  
Stentless Bioprosthesis ◽  
Transcatheter Heart Valve ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals First-in-Human Use of the Next-generation ProtEmbo Cerebral Embolic Protection System During Transcatheter Aortic Valve-in-valve Implantation

2021 ◽  
Vol 16 (Supplement 1) ◽  
pp. 1-4
Author(s):  
Dariusz Jagielak ◽  
Radoslaw Targonski ◽  
Dariusz Ciecwierz
Keyword(s):  
Aortic Valve ◽  
Aortic Arch ◽  
Aortic Regurgitation ◽  
Heart Valve ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Valve In Valve ◽  
Human Use ◽  
Valve Implantation

Cerebral embolic protection (CEP) devices aim to reduce the risk of periprocedural cerebrovascular events during transcatheter aortic valve implantation (TAVI). Here, the authors describe the first-in-human experience with the ProtEmbo Cerebral Protection System (Protembis), a next-generation CEP device, during TAVI. This case is part of a larger European trial evaluating the safety and performance of this device. After deployment of the ProtEmbo in the aortic arch, a first transcatheter heart valve was implanted. Despite postdilatation, moderate to severe aortic regurgitation persisted. The operating team decided to perform a valve-in-valve procedure using a second transcatheter heart valve. The ProtEmbo demonstrated good coverage of all three head vessels and no interaction with TAVI catheters in the aortic arch throughout the entire procedure. No adverse events were observed during hospitalisation or follow-up, and there was a significant reduction in aortic regurgitation at follow-up echocardiography. Despite a challenging overall procedure with presumably high embolic burden, diffusion-weighted MRI at follow-up showed a low number (n=3) and volume (156 mm3) of new hyperintense lesions. The first-in-human use of the ProtEmbo was safe and feasible, despite a challenging TAVI valve-in-valve procedure.

scholarly journals Optimising the Haemodynamics of Aortic Valve-in-valve Procedures

2017 ◽  
Vol 12 (01) ◽  
pp. 40 ◽  
Author(s):  
Ren Jie Yao ◽  
Matheus Simonato ◽  
Danny Dvir ◽  
◽  
◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Standard Of Care ◽  
Common Adverse Event ◽  
Mechanical Valves ◽  
Transcatheter Heart Valve ◽  
Implantation Depth ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Bioprosthetic surgical valves are increasingly implanted during cardiac surgery, instead of mechanical valves. These tissue valves are associated with limited durability and as a result transcatheter valve-in-valve procedures are performed to treat failed bioprostheses. A relatively common adverse event of aortic valve-in-valve procedures is residual stenosis. Larger surgical valve size, supra-annular transcatheter heart valve type, as well as higher transcatheter heart valve implantation depth, have all been shown to reduce the incidence of elevated post-procedural gradients. With greater understanding of technical considerations and surgical planning, valve-invalve procedures could be more effective and eventually may become the standard of care for our increasingly ageing and comorbid population with failed surgical bioprostheses.

scholarly journals Bioprosthetic Aortic Valve Fracture During Valve-in-valve Transcatheter Aortic Valve Implantation

2019 ◽  
Vol 14 (3) ◽  
pp. 147-151 ◽  
Author(s):  
John Phineas O’Donnell ◽  
Cróchán J O’Sullivan
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Great Promise ◽  
Ageing Population ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Valve In Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

The limited durability of surgical bioprostheses, combined with an ageing population, has led to an increasing demand for replacing degenerated bioprosthetic surgical heart valves, which is projected to increase. Valve-in-valve transcatheter aortic valve implantation involves implanting a transcatheter heart valve within a degenerated bioprosthetic surgical heart valve. A significant minority of patients, however, are left with a suboptimal haemodynamic result with high residual gradients. This is more common with smaller surgical bioprostheses, and may be associated with a worse prognosis. The novel concept of fracturing the previously implanted bioprosthetic surgical heart valve during valve- in-valve transcatheter aortic valve implantation to create a more favourable haemodynamic profile has shown great promise, particularly in smaller valves. Herein, we describe the benefits, limitations and potential complications of this novel approach.

Valve-in-Valve Implantation of a Sapien 3 Transcatheter Heart Valve for Reduction of Paravalvular Regurgitation Despite Optimal Placement of the First Transcatheter Heart Valve

2017 ◽  
Vol 33 (4) ◽  
pp. 555.e13-555.e15
Author(s):  
Ayoub El Hammiri ◽  
Jeannot Potvin ◽  
Jean-François Gobeil ◽  
Nicolas Noiseux ◽  
Louis-Mathieu Stevens ◽  
...  
Keyword(s):  
Heart Valve ◽  
Optimal Placement ◽  
Transcatheter Heart Valve ◽  
Valve In Valve ◽  
Sapien 3 ◽  
Valve Implantation

Jailing of a Pacemaker Lead During Tricuspid Valve-in-Valve Implantation With an Edwards SAPIEN XT Transcatheter Heart Valve

2015 ◽  
Vol 31 (6) ◽  
pp. 819.e9-819.e11 ◽  
Author(s):  
Jean-Michel Paradis ◽  
Mathieu Bernier ◽  
Christine Houde ◽  
Éric Dumont ◽  
Daniel Doyle ◽  
...  
Keyword(s):  
Heart Valve ◽  
Tricuspid Valve ◽  
Pacemaker Lead ◽  
Transcatheter Heart Valve ◽  
Edwards Sapien ◽  
Valve In Valve ◽  
Valve Implantation
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