Transcatheter Valve-in-Valve Implantation — A New Option for Failed Bioprostheses

Promising results from a small case series could be good news for patients with no or few alternatives.

Reoperation for structural failure of bioprosthetic heart valves carries considerable surgical risk. In this report, investigators describe the results of transcatheter heart valve implantation in 24 patients with degenerating bioprostheses. The failing valves were aortic in 10 patients, mitral in 7, pulmonary in 6, and tricuspid in 1. All patients were ineligible for repeat surgery or at high risk for complications because of ≥2 prior thoracotomies, complex congenital heart disease, severe double-valve disease, or other comorbidities. Mean predicted 30-day mortality according to the Society of Thoracic Surgeons risk score was 11% in patients with failing aortic valves and 15% in patients with failing mitral valves.

All patients received bal…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)