Transcatheter aortic valve-in-valve implantation within stentless landing zones: Procedural insights from a single-center experience.
Catheter Cardiovasc Interv
; 102(2): 328-338, 2023 08.
Article
em En
| MEDLINE
| ID: mdl-37393603
ABSTRACT
BACKGROUND:
Valve-in-valve (VIV) transcatheter aortic valve implantation (TAVI) is a less invasive therapeutic option compared with redo surgical valve replacement for high-risk patients. Relative to procedures within stented surgical valves, VIV-TAVI within stentless valves is associated with a higher complication rate due to challenging underlying anatomy and absence of fluoroscopic landmarks.AIMS:
We share a single-center experience with VIV-TAVI in stentless valves, discussing our procedural insights and associated outcomes.METHODS:
Our institutional database was queried, and 25 patients who had undergone VIV-TAVI within a stentless bioprosthesis, homograft, or valve-sparing aortic root replacement between 2013 and 2022 were found. Outcome endpoints were based on the Valve Academic Research Consortium-3 criteria.RESULTS:
The mean age of the cohort was 69.5 ± 13.6 years. VIV implantation was performed within a homograft in 11 patients, a stentless bioprothesis in 10 patients, and a valve-sparing aortic root replacement in 4 patients. Nineteen (76%) balloon-expandable valves, 5 (20%) self-expanding valves, and one mechanically-expandable (4%) valve were implanted with 100% procedural success, with no instances of significant paravalvular leak, coronary occlusion, or device embolization. There was one (4%) in-hospitality mortality after an emergency procedure; one (4%) patient experienced a transient ischemic attack; and two (8%) patients required permanent pacemaker implantation. The median length of hospital stay was 2 days. After a median follow-up time of 16.5 months, valve function was acceptable in all patients with available data.CONCLUSION:
VIV-TAVI within stentless valves can be safely performed with methodical procedural technique and can provide clinical benefit in patients at high reoperation risk.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
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Bioprótese
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Próteses Valvulares Cardíacas
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Implante de Prótese de Valva Cardíaca
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Substituição da Valva Aórtica Transcateter
Limite:
Aged
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Aged80
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article