Key result
Transcatheter sandwich valve-in-valve shows favorable early outcomes and potential complication reduction in pure AR.
Why the study?
No commercial on-label transfemoral TAVR device for aortic regurgitation is available and off-label self-expanding devices have elevated early mortality and complications due to weak anchoring force.
Does the transcatheter "sandwich" valve-in-valve implantation (SVIV) technique reduce complications in high-risk patients with pure aortic regurgitation?
Case Report (n=7)
Does the transcatheter "sandwich" valve-in-valve implantation (SVIV) technique reduce complications in high-risk patients with pure aortic regurgitation?
The novel transcatheter "sandwich" valve-in-valve technique offers a potentially safer off-label TAVR approach for high-risk patients with pure aortic regurgitation.
No commercial “on-label” transfemoral transcatheter aortic valve replacement (TAVR) device for aortic regurgitation (AR) is available in most countries. TAVR for AR with an “off-label” self-expanding device has shown acceptable procedural success but it elevated rates of early mortality and other complications. Valve disposition or displacement frequently occurs during transfemoral TAVR (TF-TAVR) for AR with a self-expanding valve, because of weak anchoring force. To overcome this problem, we propose a transcatheter “sandwich” valve-in-valve implantation (SVIV) technique, which has achieved good results. Our initial results and experience in a case series comprising seven patients suggest that the SVIV technique using commercially available self-expanding valves may be an option for treating selected patients with AR with high risk for surgical valve replacement. Compared with the traditional method, this technique can decrease the incidence of complications, particularly conduction block, but several technical details require the operator’s attention. Additional research is required to confirm the superiority of this technology.
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Pan et al. (2024) conducted a case report in Pure aortic regurgitation (n=7). Transcatheter sandwich valve-in-valve implantation (SVIV) technique vs. Traditional method was evaluated. In a case series of 7 high-risk patients with pure aortic regurgitation, the transcatheter sandwich valve-in-valve implantation technique achieved good initial results and may decrease complications.
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