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Transcatheter Valve-in-Valve Implantation for Failed Surgical Bioprosthetic Valves

2011; Elsevier BV; Volume: 58; Issue: 21 Linguagem: Inglês

10.1016/j.jacc.2011.09.009

1558-3597

Ronen Gurvitch, Anson Cheung, Jian Ye, David A. Wood, Alexander B. Willson, Stefan Toggweiler, Ronald K. Binder, John G. Webb,

Cardiac Structural Anomalies and Repair

When bioprosthetic cardiac valves fail, reoperative valve replacement carries a higher risk of morbidity and mortality compared with initial valve replacement. Transcatheter heart valve implantation may be a viable alternative to surgical aortic valve replacement for high-risk patients with native aortic stenosis, and valve-in-valve (V-in-V) implantation has been successfully performed for failed surgical bioprostheses in the aortic, mitral, pulmonic, and tricuspid positions. Despite some core similarities to transcatheter therapy of native valve disease, V-in-V therapy poses unique clinical and anatomic challenges. In this paper, we review the challenges, selection criteria, techniques, and outcomes of V-in-V implantation.