Author + information
- Uri Landes1,
- Danny Dvir2,
- Wolfgang Schoels3,
- Christophe Tron4,
- Stephan Ensminger5,
- Matheus Simonato dos Santos6,
- Ulrich Schäfer7,
- Matjaz Bunc8,
- Gabriel Aldea9,
- Alfredo Cerillo10,
- Stephan Windecker11,
- Martin Andreas12,
- John Webb2 and
- Ran Kornowski13
- 1Rabin Medical Center, Tel Aviv, Israel
- 2Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada
- 3Heart Center Duisburg, Duisburg, Germany
- 4Rouen Cedex 1, France
- 5Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
- 6Federal University of Sao Paulo, Sao Paulo, São Paulo, Brazil
- 7University Heart Center Hamburg, Hamburg, Germany
- 8University Medical Center Ljubljana, Ljubljana, Slovenia
- 9University of Washington, Seattle, Washington, United States
- 10Fondazione Toscana G. Monasterio, Massa, Massa and Carrara, Italy
- 11University Hospital Bern, Bern, Switzerland
- 12Medical University of Vienna, Vienna, Austria
- 13Rabin Medical Center, Petach Tikva, Israel
Transcatheter valve-in-valve implantation (ViV) has evolved as a viable strategy in suitable cases of patients with a failed surgical bioprosthesis heat valves (SHV). Sutureless aortic bioprosthesis are a relatively new subcategory of the lasts. Our aim was to evaluate the performance of ViV in sutureless SHVs.
An international, multicenter registry was developed to collect data on ViV cases performed in sutureless surgical valves as part of the Valve-in-Valve International Data (VIVID) Registry. A total of 25 patients with failed sutureless SHV treated by ViV were evaluated.
Mean patients age was 80.4 ± 8 years, 80% females, STS-PROM 9.4 ± 5.3%. Sutureless SHV size ranged from 21 to 25 (median 23) mm and included the Perceval (Sorin Biomedica, Salugia, Italy; n = 21), the ATS 3F Enable (Medtronic Inc., Minneapolis, MN, USA; n = 3) and the Intuity (Edwards Lifesciences, Irvine, CA, USA; n=1). The indication for ViV was significant stenosis (n = 5), regurgitation (n = 5) or a mixture of the two (n = 15). The ViV was attempted via the trans-femoral (n = 18) and trans-apical (n = 7) approaches with the SAPIEN XT (n = 10), Sapien 3 (n = 7) and CoreValve (n = 8), sizes 23mm to 29 mm (median 23 mm). There were 2 cases (9%) with a need for permanent pacemaker implantation, 1 case with major vascular complication and 1 case with major/life threatening bleeding. Implantation was successful in all patients, with an average postprocedural mean gradient of 14.1 ± 8.8 mmHg. There were no cases with AR > moderate and no need for 2nd prosthesis implantation. There was no coronary obstruction in any of these cases and one patient died during 30-day follow-up (4%).
ViV implantation inside selected failed sutureless SHV is feasible and associated with reasonable post procedural hemodynamics. The safety of this approach will be further evaluated in the future.
STRUCTURAL: Valvular Disease: Aortic