Key result
Open valve-in-valve TAVI enables single-stage treatment of combined aortic and mitral pathology without explantation.
Why the study?
A surgical dilemma exists when concomitant procedures are required and bioprosthetic explantation is technically hazardous, exposing patients to excess risk.
Case Report (n=1)
Open valve-in-valve implantation with a transcatheter heart valve during concomitant open cardiac surgery offers a feasible strategy to avoid hazardous explantation of degenerated rapid-deployment aortic bioprostheses.
Transcatheter valve-in-valve replacement is an established option for degenerated surgical bioprostheses, particularly in high-risk or redo settings. However, a surgical dilemma arises when concomitant procedures are required and bioprosthetic explantation is technically hazardous, exposing the patient to excess risk. We report the use of a balloon-expandable transcatheter aortic valve in an open surgical setting as a valve-in-valve implantation within a degenerated rapid-deployment aortic bioprosthesis, in a patient who also required mitral valve replacement. This open valve-in-valve strategy avoided high-risk explantation while allowing definitive treatment of both aortic and mitral valve pathology in a single operation.
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Philipsheck et al. (2026) conducted a case report in Degenerated rapid deployment aortic bioprosthesis with concomitant mitral valve pathology (n=1). Open valve-in-valve transcatheter aortic valve implantation was evaluated. Open valve-in-valve transcatheter aortic valve implantation avoided high-risk explantation and allowed definitive treatment of both aortic and mitral valve pathology in a single operation.
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