Transcatheter aortic and mitral valve implantations for failed bioprosthetic heart valves

Autor: Danny, Dvir, Abid, Assali, Hana, Vaknin-Assa, Alexander, Sagie, Yaron, Shapira, Eyal, Porat, Ran, Kornowski
Rok vydání: 2011
Předmět:
Zdroj: The Journal of invasive cardiology. 23(9)
ISSN: 1557-2501
Popis: Restoring degenerated bioprosthetic valves by transcatheter valve implantation may obviate the need for redo surgery in carefully selected patients. We present our initial experience with valve-in-valve (VIV) procedures for failed aortic and mitral bioprosthetic valves.Data were collected for all patients who underwent VIV procedures at a tertiary medical center (n = 6). Findings were analyzed and compared with those for transcatheter valve implantation in native valves at the same center during the last 3 years (n = 84).Six patients of mean age 78.3 ± 13.8 years (range, 51-87) underwent VIV procedures with the CoreValve (n = 4) or Edwards-SAPIEN device (n = 2). Four (66%) had a failed prosthetic aortic valve, and 2 (33%) had a failed prosthetic mitral valve. Regurgitation accounted for valve failure in 83.3% of the VIV group versus 1.2% of the comparison group (p0.001). Procedural success and 30-day survival rates were 100%. Patient functional class improved significantly from 0% class I/II, 50% class III, and 50% class IV before the procedure to 66% class I, 33% class II, and 0% class III/IV after (p0.001).This preliminary experience demonstrates that in carefully selected cases, transcathether valve implants can be safely and effectively deployed in stenotic and/or regurgitant degenerated bioprosthetic valves. Further evaluations in larger series are needed.
Databáze: OpenAIRE