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July 22, 2019Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery

Valve-in-Valve TAVR: State-of-the-Art Review

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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.

Design

State-of-the-art review

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.

Authors

JEJ. James EdelmanJKJaffar M. KhanTRToby Rogers

Discussion

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Overview

Demands individualized risk assessment before use; leaves open need for randomized comparisons to reoperative surgery.

Structured PICO

P
Population
High-risk and inoperable patients with surgically implanted bioprostheses requiring re-intervention for structural valve deterioration
I
Intervention
Valve-in-valve transcatheter aortic valve replacement (ViV 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.

Cite This Study

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.

synapsesocial.com/papers/6a9c0b147fa1be8784a6b057https://doi.org/10.1177/1556984519858020
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