Key result
Bioprosthetic valve fracture and remodeling can facilitate valve-in-valve TAVR by optimally expanding the transcatheter heart valve and reducing the residual transvalvular gradient.
Why the study?
VIV TAVR often results in suboptimal transcatheter heart valve expansion and patient-prosthesis mismatch, particularly in small surgical valves.
This article provides a practical guide on patient selection, procedural planning, and technical insights for performing bioprosthetic valve fracture and remodeling during valve-in-valve TAVR.
May optimize hemodynamics in small-valve VIV TAVR; leaves open durability, safety, and outcomes in prospective trials.
Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement.VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves.Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively.This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.
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Allen et al. (2021) conducted a review in Failed surgical tissue valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) was evaluated. Bioprosthetic valve fracture and remodeling can facilitate valve-in-valve TAVR by optimally expanding the transcatheter heart valve and reducing the residual transvalvular gradient.
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