Key result
Bioprosthetic valve fracture as an adjunct to valve-in-valve TAVR is associated with specific complications, and reviewing these cases provides insight into best practices for the procedure.
Why the study?
As bioprosthetic valve fracture as an adjunct to valve-in-valve TAVR has become more widely used to address patient-prosthesis mismatch, complications specific to the procedure have become more apparent.
This review outlines the emerging complications associated with bioprosthetic valve fracture during valve-in-valve TAVR, providing guidance on best practices to improve procedural safety.
Alerts operators to fracture risks in valve-in-valve TAVR; leaves open optimal technique pending prospective data.
Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is a safe and effective method of treating patients with failed bioprosthetic surgical valves (BSVs) at high risk of reoperation. However, one of the major limitations of VIV TAVR is patient–prosthesis mismatch (PPM), particularly in small BSVs. PPM is associated with increased mortality following VIV TAVR. Bioprosthetic valve fracture (BVF) as an adjunct to VIV TAVR has been shown to be a safe and effective method in terms of improving postprocedural hemodynamics and eliminating PPM after VIV TAVR in several case series. As BVF has become more widely used, complications specific to the procedure have become more apparent. This review focuses on the knowledge gained from several cases of BVF for VIV TAVR, and how these specific examples lend insight into best practices when performing this procedure.
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Saxon et al. (2019) conducted a review in Failed bioprosthetic surgical valves. Bioprosthetic valve fracture (BVF) as an adjunct to VIV TAVR was evaluated. Bioprosthetic valve fracture as an adjunct to valve-in-valve TAVR is associated with specific complications, and reviewing these cases provides insight into best practices for the procedure.
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