
Bioprosthetic Aortic Valve Fracture During Valve-in-valve Transcatheter Aortic Valve Implantation
Author(s) -
John P. O'Donnell,
Cróchán J. O’Sullivan
Publication year - 2019
Publication title -
interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 11
eISSN - 1756-1477
pISSN - 1756-1485
DOI - 10.15420/icr.2019.08.r2
Subject(s) - medicine , heart valve , cardiology , aortic valve , hemodynamics , surgery
The limited durability of surgical bioprostheses, combined with an ageing population, has led to an increasing demand for replacing degenerated bioprosthetic surgical heart valves, which is projected to increase. Valve-in-valve transcatheter aortic valve implantation involves implanting a transcatheter heart valve within a degenerated bioprosthetic surgical heart valve. A significant minority of patients, however, are left with a suboptimal haemodynamic result with high residual gradients. This is more common with smaller surgical bioprostheses, and may be associated with a worse prognosis. The novel concept of fracturing the previously implanted bioprosthetic surgical heart valve during valve- in-valve transcatheter aortic valve implantation to create a more favourable haemodynamic profile has shown great promise, particularly in smaller valves. Herein, we describe the benefits, limitations and potential complications of this novel approach.