Key result
Transcatheter aortic valve replacement as a valve-in-valve procedure was technically feasible and resulted in clinical improvement in all four patients with failed Perceval sutureless valves.
Why the study?
When sutureless or rapid deployment aortic valve substitutes fail, reports of transcatheter valve-in-valve replacement have been limited to small case series.
Does transcatheter aortic valve replacement (TAVR) as a valve-in-valve procedure improve clinical and hemodynamic outcomes in patients with failed sutureless Perceval valves?
Case Report (n=4)
No
Does transcatheter aortic valve replacement (TAVR) as a valve-in-valve procedure improve clinical and hemodynamic outcomes in patients with failed sutureless Perceval valves?
TAVR as a valve-in-valve procedure is technically feasible and provides clinical improvement for patients with failed sutureless Perceval valves, though post-procedural gradients may remain elevated in some cases.
Supports feasibility of valve-in-valve TAVR for failed Perceval valves; leaves open durability and safety in larger populations.
In recent years, sutureless valves (SV) and rapid deployment valves (RDVs) have become interesting aortic valve substitutes, especially in minimally invasive aortic valve surgery, as they reduce cardio-pulmonary bypass and cross-clamp times. There are two valve types available, the sutureless Perceval and the rapid deployment Intuity valve prosthesis. When these valves fail, besides surgical re-replacement, the valve-in-valve concept has been reported in a small series of case reports. Our own experience includes four cases of failed Perceval valves, in which a balloon-expandable transcatheter valve was implanted in three patients, and a self-expanding transcatheter valve was implanted in a fourth patient. Here, we present these four cases with a focus on the specific valve design of the Perceval valve, as well as on important technical aspects. All cases were performed successfully with clinical improvement. Transcatheter aortic valve replacement (TAVR) as a valve-in-valve concept seems to be a valuable option in selected patients with failed sutureless or RDVs.
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Misfeld et al. (2020) conducted a case report in Failed Perceval sutureless aortic valves (n=4). Transcatheter aortic valve replacement (TAVR) was evaluated on Procedural success and clinical improvement. Transcatheter aortic valve replacement as a valve-in-valve procedure was technically feasible and resulted in clinical improvement in all four patients with failed Perceval sutureless valves.
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