Valve-in-Valve Transcatheter Aortic Valve Implantation: A Novel Approach to Treat Paravalvular Leak

Pranav Loyalka; Kelsey B Montgomery; Tom C Nguyen; Richard W Smalling; Melissa Howe; Keshava Rajagopal

doi:10.1016/j.athoracsur.2017.05.083

Valve-in-Valve Transcatheter Aortic Valve Implantation: A Novel Approach to Treat Paravalvular Leak

Pranav Loyalka, Kelsey B Montgomery, Tom C Nguyen, Richard W Smalling, Melissa Howe, Keshava Rajagopal

Research output: Contribution to journal › Article › peer-review

Abstract

Enlarging or "cracking" a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation. The patient underwent valve-in-valve TAVI with valve cracking. This successfully treated both the stenosis and the PVL with regurgitation.

Original language	English
Pages (from-to)	e325-e327
Journal	The Annals of thoracic surgery
Volume	104
Issue number	4
DOIs	https://doi.org/10.1016/j.athoracsur.2017.05.083
State	Published - Sep 2017
Externally published	Yes

Keywords

Anastomotic Leak/diagnostic imaging
Aortic Valve Insufficiency/complications
Aortic Valve Stenosis/complications
Bioprosthesis
Echocardiography/methods
Female
Follow-Up Studies
Heart Failure/diagnosis
Heart Valve Prosthesis Implantation/adverse effects
Humans
Middle Aged
Patient Safety
Prosthesis Failure
Recovery of Function
Reoperation
Risk Assessment
Stents
Transcatheter Aortic Valve Replacement/methods
Treatment Outcome

Access to Document

10.1016/j.athoracsur.2017.05.083

Cite this

@article{297c9d9076db4a26abe42c9949d33a9a,

title = "Valve-in-Valve Transcatheter Aortic Valve Implantation: A Novel Approach to Treat Paravalvular Leak",

abstract = "Enlarging or {"}cracking{"} a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation. The patient underwent valve-in-valve TAVI with valve cracking. This successfully treated both the stenosis and the PVL with regurgitation.",

keywords = "Anastomotic Leak/diagnostic imaging, Aortic Valve Insufficiency/complications, Aortic Valve Stenosis/complications, Bioprosthesis, Echocardiography/methods, Female, Follow-Up Studies, Heart Failure/diagnosis, Heart Valve Prosthesis Implantation/adverse effects, Humans, Middle Aged, Patient Safety, Prosthesis Failure, Recovery of Function, Reoperation, Risk Assessment, Stents, Transcatheter Aortic Valve Replacement/methods, Treatment Outcome",

author = "Pranav Loyalka and Montgomery, \{Kelsey B\} and Nguyen, \{Tom C\} and Smalling, \{Richard W\} and Melissa Howe and Keshava Rajagopal",

year = "2017",

month = sep,

doi = "10.1016/j.athoracsur.2017.05.083",

language = "English",

volume = "104",

pages = "e325--e327",

journal = "The Annals of thoracic surgery",

issn = "0003-4975",

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T1 - Valve-in-Valve Transcatheter Aortic Valve Implantation

T2 - A Novel Approach to Treat Paravalvular Leak

AU - Loyalka, Pranav

AU - Montgomery, Kelsey B

AU - Nguyen, Tom C

AU - Smalling, Richard W

AU - Howe, Melissa

AU - Rajagopal, Keshava

PY - 2017/9

Y1 - 2017/9

N2 - Enlarging or "cracking" a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation. The patient underwent valve-in-valve TAVI with valve cracking. This successfully treated both the stenosis and the PVL with regurgitation.

AB - Enlarging or "cracking" a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation. The patient underwent valve-in-valve TAVI with valve cracking. This successfully treated both the stenosis and the PVL with regurgitation.

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KW - Aortic Valve Insufficiency/complications

KW - Aortic Valve Stenosis/complications

KW - Bioprosthesis

KW - Echocardiography/methods

KW - Female

KW - Follow-Up Studies

KW - Heart Failure/diagnosis

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Middle Aged

KW - Patient Safety

KW - Prosthesis Failure

KW - Recovery of Function

KW - Reoperation

KW - Risk Assessment

KW - Stents

KW - Transcatheter Aortic Valve Replacement/methods

KW - Treatment Outcome

U2 - 10.1016/j.athoracsur.2017.05.083

DO - 10.1016/j.athoracsur.2017.05.083

M3 - Article

C2 - 28935328

SN - 0003-4975

VL - 104

SP - e325-e327

JO - The Annals of thoracic surgery

JF - The Annals of thoracic surgery

IS - 4

ER -