Key result
Valve-in-valve TAVR serves as an alternative to reoperative surgery for high-risk patients with structural valve deterioration, despite higher risks of prosthesis-patient mismatch and coronary obstruction.
Why the study?
Surgically implanted bioprostheses increasingly require re-intervention for structural valve deterioration, but ViV TAVR poses challenges including higher rates of prosthesis-patient mismatch and coronary obstruction compared to native valve TAVR.
Valve-in-valve TAVR serves as an alternative to reoperative surgery for high-risk patients with structural valve deterioration, though it carries specific procedural challenges.
Answers are grounded in this paper and cite their sources.
Demands individualized risk assessment before use; leaves open need for randomized comparisons to reoperative surgery.
An increasing number of surgically implanted bioprostheses will require re-intervention for structural valve deterioration. Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an alternative to reoperative surgery, currently approved for high-risk and inoperable patients. Challenges to the technique include higher rates of prosthesis-patient mismatch and coronary obstruction, compared to native valve TAVR. Herein, we review results of ViV TAVR and novel techniques to overcome the aforementioned challenges.
No takes yet. Share an insight, caveat, or question.
Edelman et al. (2019) conducted a review in Structural valve deterioration of surgically implanted bioprostheses. Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) vs. Reoperative surgery / Native valve TAVR was evaluated. Valve-in-valve TAVR serves as an alternative to reoperative surgery for high-risk patients with structural valve deterioration, despite higher risks of prosthesis-patient mismatch and coronary obstruction.
Synapse has enriched 10 related papers. Consider them for comparative context: