Transcatheter aortic valve implantation in degenerative sutureless perceval aortic bioprosthesis

Uri Landes, Alexander Sagie, Ran Kornowski

Research output: Contribution to journalArticlepeer-review

Abstract

Sutureless aortic bioprostheses (SAB) are increasingly being used to provide shorter cross-clamp time. Valve-in-valve transcatheter aortic valve replacement (VIV-A) is shown to be effective and safe in the vast majority of patients with degenerated bioprosthetics, yet its' use in SAB failure is infrequent. We present a case of balloon-expandable VIV-A in an 80-year-old woman who suffered severe symptomatic aortic regurgitation in a failed Perceval S 21-mm valve. Computed tomography scan demonstrated a deformed valve. Our heart team favored a percutaneous VIV-A over reoperation due to the patients' high surgical risk. An Edwards-Sapien XT 23 mm was successfully deployed with excellent results. The patient remained asymptomatic following 6 months. As other bioprosthesis, some sutureless valves are condemned to structural valve degeneration. Because VIV-A is being established for managing degenerative bioprosthesis in high risk patients, it is cardinal to identify its role in novel degenerative sutureless valves. SAB were introduced to the clinical market only 5–7 years ago. The absence of sutures may theoretically impose risk for valve instability when adding a transcatheter sutureless valve inside the first one. Our successful experience was very reassuring. We report its feasibility because we believe it should provide support for further investigation on VIV-A within novel SAV.

Original languageEnglish
Pages (from-to)1000-1004
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume91
Issue number5
DOIs
StatePublished - 1 Apr 2018

Keywords

  • structural valve degeneration
  • sutureless bioprosthesis
  • valve-in-valve transcatheter valve replacement

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