Transcatheter aortic valve-in-valve implantation of a CoreValve in a JenaValve prosthesis: a case report

Figures

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  Fig. 1. Planning of intervention using the app “Valve in valve” by Dr Vinayak Bapat. The red marker shows the “cusp feelers”, the green line shows the intended “landing zone” of the new valve

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  Fig. 2. Additional planning of intervention using cardiac computed tomography: given is the analysis for left coronary cusp (analyses of right and non-coronary cusp are not shown). Red arrow, “feeler” of JenaValve; blue arrow, lowest point of JenaValve; yellow arrow, aortic annulus in at deepest point in left coronary cusp; green line, intended level for positioning of the lowest point of CoreValve Evolut R prosthesis determined by our Transcatheter aortic valve implantation-Team (not above the original aortic annulus and not deeper than lowest point of JenaValve avoiding possible interference with mitral valve). LVOT left ventricular outflow tract

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  Fig. 3. Fluoroscopy during implantation of the CoreValve prosthesis within the JenaValve prosthesis demonstrating the applied position with the distal end being positioned between the “cusp feelers” and the distal end of the JenaValve

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  Fig. 4. Fluoroscopy during implantation of the CoreValve prosthesis within the JenaValve prosthesis demonstrating the applied position with the distal end being positioned between the “cusp feelers” and the distal end of the JenaValve

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  Fig. 5. Angiogram after implantation of the CoreValve Evolut R prosthesis within the JenaValve prosthesis demonstrating planned position of the CoreValve Evolut R prosthesis (red marker and green line as planned in Fig. 1)