The size of the original bioprosthetic valve impacts long term mortality, as does the type of bioprosthetic valve used in percutaneous reinterventions. The number of patients with failed bioprosthesis is on the rise, mainly due to increased life expectancy. Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) has become more and more common these days and…
Surgical Valve Replacement Might Soon Be History
Patients with dysfunctional biological prosthetic valves have better outcomes with TAVR vs. surgical reintervention, beyond surgical risk. This study outcomes might even call into question the age cutoff to consider a mechanical vs. a biological prosthesis at first surgery. This analysis recently published in JACC looked at the outcomes of both possible strategies to treat…
Valve-in-Valve: Good Evolution at Long-Term
Courtesy of Dr. Carlos Fava. In the last decades, there has been a marked increase in the use bioprosthetic valves in aortic position given their benefits over mechanical valves. However, long term follow-up has shown structural valve degeneration (SVD). Given the risk of a second surgery after TAVR, valve-in-valve (ViV) has been on the rise,…
Valve in Valve Presents Better Evolution than re-SARV
Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement with bioprosthesis has proved its benefits, but it fails after 10 to 15 years. Transcatheter aortic valve replacement has been shown valid, especially in high risk patients, but we still have little information and no “head to head” studies to know what is best in this…
Good News at 3 Years for “Valve-in-Valve”
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…
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