In this new era, the paradigm to treat the whole spectrum of transcatheter aortic valve replacement (TAVR) patients has started to shift beyond risk. However, broadening the spectrum raises the question of durability, which is why any long-term TAVR outcomes in any context are welcome. This specific study studied TAVR durability in the treatment of…
TCT 2018 | PARTNER 2 Valve-in-Valve: Clinical and Hemodynamic Results Maintained in the Long Term
The 1-year follow-up for this study was published last year in JACC, and it showed that transcatheter aortic valve replacement (TAVR) in failed bioprosthetic valves has low rates of complications, boosts significant hemodynamic improvement, and results in relatively low mortality. Now, the 3-year results are presented at TCT 2018. The study followed 365 patients who underwent valve-in-valve…
Post-Dilation in Valve-in-Valve Implantation Offers Hemodynamic Improvement
Courtesy of Dr. Carlos Fava. A significant number of patients present severe aortic stenosis and undergo surgery with 19-to-21-mm bioprostheses. These patients frequently evolve with high gradients and receive Valve-in-Valve (ViV) implantation. In about a third of patients with high post-procedural gradient (≥20 mmHg), this has been associated with poor outcomes. This study analyzed 30 patients who underwent…
Failing Surgical Bioprosthesis: A Challenge on the Rise
Courtesy of Dr. Carlos Fava. The gold standard for failing aortic bioprosthesis has traditionally been surgery. However, since the first valve in valve (TAV-in-SAV) report in 2007, by Wenaweser, transcatheter valve implantation has emerged as a valid alternative. Even so, at present there is not enough scientific evidence in this regard. The present study analyzed…
VIVA Post-Market Study: More Evidence for the Valve-in-Valve Technique
Courtesy of the SBHCI. Bioprosthetic surgically-implanted valves degenerate over time, while patients become too old and are at high risk for reoperation. Transcatheter aortic valve implantation inside a deteriorated surgically-implanted valve (a valve-in-valve procedure) is an emerging alternative. The VIVA trial was designed to offer systematic and prospective data from patients treated with…
Further Evidence on Managing Dysfunctioning Bioprostheses with Balloon-Expandable Prostheses
Early experience with the valve-in-valve technique in the treatment of failed bioprosthetic surgical valves in transcatheter aortic valve replacement (TAVR) has yielded acceptable acute procedural results. This turned the technique into another therapeutic option, one that could even cause the reassessment of the age limit for the surgical implantation of a mechanical or bioprosthesis valve.…
Valve-in-Valve: High or Low Implantation for Better Outcomes?
Original Title: Transcatheter Replacement of Failed Bioprosthetic Valve. Large Multicenter Assessment of the Effect of Implantation Depth on Hemodynamics after Aortic Valve-in Valve. Reference: Matheus Simonato, et al. Circ. Cardiovasc. Interv 2016;9:e003651 Courtesy of Dr. Carlos Fava. At present, most patients undergoing surgical valve replacement receive a bioprosthetic valve, which lasts from 10 to…
Transcatheter Tricuspid Valve in valve
Original Title: Transcatheter Tricuspid Valve-in-Valve Implantation for the Treatment of Dysfunctional Surgical Bioprosthetic Valve. An International, Multicenter Registry Study. Reference: Doff B. McElhinney, et al. Circulation 2016;133:1582-93 Courtesy of Dr. Carlos Fava. Transcatheter tricuspid valve in valve implantation (TVIV) is infrequent, complex and biological valves last from 10 to 15 years. Reoperation is associated with high…