CIBERCV, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain.
Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Catheter Cardiovasc Interv. 2020 Mar 1;95(4):E120-E122. doi: 10.1002/ccd.28347. Epub 2019 May 29.
Valve-in-valve (ViV) transcatheter procedures have emerged as a feasible, less-invasive treatment option for bioprosthetic structural valve deterioration. However, in the presence of a small bioprosthesis, a significant residual gradient after ViV procedures often occurs and has been associated with poorer clinical outcomes. We report the use of the self-expandable supra-annular ACURATE neo™ valve to treat degenerated Mitroflow (Sorin) aortic bioprosthesis with severe residual elevated gradients followed by valve fracture with a postdilation using a noncompliant balloon leading to significant reduction in residual gradients. In conclusion, the use of ACURATE neo™ valve followed by the controlled fracture of the surgical bioprosthesis frame with a noncompliant balloon is a safe and effective approach for patients with Mitroflow® failing valves and residual elevated gradient after transcatheter aortic valve replacement.
经导管 Valve-in-Valve (ViV) 手术已成为治疗生物瓣结构性瓣膜衰败的一种可行的、微创的治疗选择。然而，在存在小的生物瓣的情况下，ViV 手术后往往会出现明显的残余梯度，并且与较差的临床结果相关。我们报告了使用自膨式 supra-annular ACURATE neo™ 瓣膜治疗退行性 Mitroflow（Sorin）主动脉生物瓣，该生物瓣存在严重的残余升高梯度，随后使用非顺应性球囊进行后扩张，导致残余梯度显著降低。总之，对于 Mitroflow®失效瓣膜和经导管主动脉瓣置换术后残余升高梯度的患者，使用 ACURATE neo™ 瓣膜，然后使用非顺应性球囊控制外科生物瓣框架的破裂是一种安全有效的方法。
