Transcatheter valve-in-valve replacement of degenerated bioprosthetic aortic valves: a single Australian Centre experience.
作者信息
Subban Vijayakumar, Savage Michael, Crowhurst James, Poon Karl, Incani Alexander, Aroney Constantine, Tesar Peter, Clarke Andrew, Raffel Christopher, Murdoch Dale, Platts David, Burstow Darryl, Saireddy Ramakrishna, Bett Nicholas, Walters Darren L
机构信息
Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai 600 037, India; Department of Cardiology, Prince Charles Hospital, Queensland 4032, Australia.
Department of Cardiology, Prince Charles Hospital, Queensland 4032, Australia.
出版信息
Cardiovasc Revasc Med. 2014 Nov-Dec;15(8):388-92. doi: 10.1016/j.carrev.2014.10.004. Epub 2014 Oct 29.
BACKGROUND
Patients with degenerated surgical bioprosthetic valves may be at high risk for further surgery because of age, comorbidities and the difficulties of repeat procedures. Percutaneous valve-in-valve implantation offers what may be a simpler and safer procedure.
METHODS
From May 2009 to March 2014 at the Prince Charles Hospital 1625 patients underwent surgical aortic valve replacement while 262 underwent transcatheter aortic valve implantation. Twelve patients had valve-in-valve implants for degenerated bioprosthetic aortic valves.
RESULTS
These implants were deployed successfully without major valvular or paravalvular regurgitation. There were no periprocedural deaths, myocardial infarcts, neurological events or major vascular complications. Two patients died after 1624 and 1319days. Median survival for the remainder is 581days; they are stable with New York Heart Association class I/II functional status although 4 have a degree of patient-prosthesis mismatch, one has moderate aortic regurgitation and one required surgery for a late aortic dissection.
CONCLUSION
Transcatheter valve-in-valve implantation is safe and effective treatment for patients with failed bioprosthetic aortic valves for whom reoperation is considered to be hazardous.
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