Key result
Off-label TAVR enables valve-in-valve replacement for a failing bioprosthesis in challenging aortic anatomy.
Why the study?
Valve-in-valve transcatheter aortic valve replacement is challenging in patients with a stiff vascular prosthesis replacing the ascending aorta and complex aortic anatomy.
Case Report (n=1)
Demonstrates the feasibility of off-label valve-in-valve TAVR in a patient with challenging aortic anatomy including a stiff vascular prosthesis and horizontal aorta.
Answers are grounded in this paper and cite their sources.
May offer a bailout option in complex post-surgical anatomy; leaves open questions of safety and durability pending larger studies.
Valve-in-valve transcatheter aortic valve replacement for failing surgical bioprosthetic valves becomes troublesome if a stiff vascular prosthesis replaces the ascending aorta. We report the off-label use of a new transcatheter aortic valve for treatment of a patient with a bioprosthetic valve with central regurgitation, a horizontal aorta, and kinking of the aortic prosthesis. (Level of Difficulty: Intermediate.)
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Marchese et al. (2022) conducted a case report in Failing surgical bioprosthetic valve with central regurgitation, horizontal aorta, and kinking of the aortic prosthesis (n=1). Off-label use of a new transcatheter aortic valve was evaluated. Off-label use of a new transcatheter aortic valve was performed for valve-in-valve replacement in a patient with a failing bioprosthesis and challenging aortic anatomy.
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