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Transcatheter aortic valve‐in‐valve‐in‐valve implantation with three‐dimensional printing guidance: A case report
Author(s) -
Basman Craig,
Seetharam Karthik,
Pirelli Luigi,
Kliger Chad A.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14614
Subject(s) - medicine , aortic valve , cardiology
Background Valve‐in‐valve implantation (ViV) has become a valid option for the treatment of bioprosthetic valve failure. We describe the first in‐man transfemoral transcatheter aortic valve replacement (TAVR) or “turducken” in a patient with previous TAVR within surgical aortic valve replacement with preprocedural guidance utilizing three‐dimensional (3D) printing and intraprocedural guidance with fusion imaging. Case Summary A 65‐year‐old male with a previous valve‐in‐valve with a transcatheter Melody valve presented with symptomatic severe valvular and paravalvular aortic incompetence. Using 3D printing for preprocedural guidance and computed tomography angiography‐fluoroscopy fusion imaging for intraprocedural guidance we successfully placed a 29 mm self‐expanding valve with minimal residual gradients. The patient continued to be asymptomatic at 1‐ and 5‐year follow‐up. Discussion We describe the first in man aortic valve‐in‐valve‐in‐valve using preprocedural guidance with 3D printing and intraprocedural guidance with fusion imaging. The valve has continued to demonstrate good function up to 5 years postprocedure suggesting that transcatheter aortic valve‐in‐valve‐in‐valve may be feasible with the proper pre‐ and intraprocedural guidance.