Bioprosthetic valve fracture: a practical guide

Keith B Allen; Adnan K Chhatriwalla; John T Saxon; Chetan P Huded; Janarthanan Sathananthan; Tom C Nguyen; Brian Whisenant; John G Webb

doi:10.21037/acs-2021-tviv-25

Bioprosthetic valve fracture: a practical guide

Keith B Allen, Adnan K Chhatriwalla, John T Saxon, Chetan P Huded, Janarthanan Sathananthan, Tom C Nguyen, Brian Whisenant, John G Webb

Research output: Contribution to journal › Review article › peer-review

Abstract

Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement. VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively. This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.

Original language	English
Pages (from-to)	564-570
Number of pages	7
Journal	Annals of cardiothoracic surgery
Volume	10
Issue number	5
DOIs	https://doi.org/10.21037/acs-2021-tviv-25
State	Published - Aug 2021
Externally published	Yes

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10.21037/acs-2021-tviv-25

Cite this

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title = "Bioprosthetic valve fracture: a practical guide",

abstract = "Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement. VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively. This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.",

author = "Allen, \{Keith B\} and Chhatriwalla, \{Adnan K\} and Saxon, \{John T\} and Huded, \{Chetan P\} and Janarthanan Sathananthan and Nguyen, \{Tom C\} and Brian Whisenant and Webb, \{John G\}",

year = "2021",

month = aug,

doi = "10.21037/acs-2021-tviv-25",

language = "English",

volume = "10",

pages = "564--570",

journal = "Annals of cardiothoracic surgery",

issn = "2225-319X",

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TY - JOUR

T1 - Bioprosthetic valve fracture

T2 - a practical guide

AU - Allen, Keith B

AU - Chhatriwalla, Adnan K

AU - Saxon, John T

AU - Huded, Chetan P

AU - Sathananthan, Janarthanan

AU - Nguyen, Tom C

AU - Whisenant, Brian

AU - Webb, John G

PY - 2021/8

Y1 - 2021/8

N2 - Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement. VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively. This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.

AB - Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is currently indicated for the treatment of failed surgical tissue valves in patients determined to be at high surgical risk for re-operative surgical valve replacement. VIV TAVR, however, often results in suboptimal expansion of the transcatheter heart valve (THV) and can result in patient-prosthesis mismatch (PPM), particularly in small surgical valves. Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) can facilitate VIV TAVR by optimally expanding the THV and reducing the residual transvalvular gradient by utilizing a high-pressure inflation with a non-compliant balloon to either fracture or stretch the surgical valve ring, respectively. This article, along with the supplemental video, will provide patient selection, procedural planning and technical insights for performing BVF and BVR.

U2 - 10.21037/acs-2021-tviv-25

DO - 10.21037/acs-2021-tviv-25

M3 - Review article

C2 - 34733685

SN - 2225-319X

VL - 10

SP - 564

EP - 570

JO - Annals of cardiothoracic surgery

JF - Annals of cardiothoracic surgery

IS - 5

ER -