open access

Vol 25, No 3 (2018)
Original articles — Interventional cardiology
Published online: 2018-01-25
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Valve in valve implantation of the CoreValve Evolut R in degenerated surgical aortic valves

Marius Schwerg, Karl Stangl, Michael Laule, Verena Stangl, Henryk Dreger
DOI: 10.5603/CJ.a2018.0004
·
Pubmed: 29570211
·
Cardiol J 2018;25(3):301-307.

open access

Vol 25, No 3 (2018)
Original articles — Interventional cardiology
Published online: 2018-01-25

Abstract

Background: The new CoreValve Evolut R has an improved design to minimize paravalvular leak­age and allows repositioning of the valve. For patients with degenerated bioprosthetic aortic valves, transcatheter aortic valve implantation (TAVI) represents a less invasive option. Herein reported are valve-in-valve (ViV) implantations of this new valve.

Methods: A total of 26 patients (mean age 79.4 ± 6.1 years, 17 males and 9 females) were treated for severe prosthesis stenosis (n = 9), severe regurgitation (n = 8) or severe combination of stenosis and regurgitation (n = 9). All patients underwent transthoracic echocardiography before and after ViV implantation.

Results: Valve-in-valve implantation of a CoreValve Evolut R was performed successfully in all pa­tients. The mean transaortic gradient for stenotic valves determined by transthoracic echocardiography was reduced significantly from 37.5 ± 15.3 mmHg in patients with prosthesis stenosis to 16.3 ± 8.2 mmHg (p < 0.001). In all cases with severe prosthesis regurgitation, regurgitation was reduced to none or mild. All-cause mortality after 30 days was 0%.

Conclusions: It was concluded that CoreValve Evolut R is well suited for ViV implantation.

Abstract

Background: The new CoreValve Evolut R has an improved design to minimize paravalvular leak­age and allows repositioning of the valve. For patients with degenerated bioprosthetic aortic valves, transcatheter aortic valve implantation (TAVI) represents a less invasive option. Herein reported are valve-in-valve (ViV) implantations of this new valve.

Methods: A total of 26 patients (mean age 79.4 ± 6.1 years, 17 males and 9 females) were treated for severe prosthesis stenosis (n = 9), severe regurgitation (n = 8) or severe combination of stenosis and regurgitation (n = 9). All patients underwent transthoracic echocardiography before and after ViV implantation.

Results: Valve-in-valve implantation of a CoreValve Evolut R was performed successfully in all pa­tients. The mean transaortic gradient for stenotic valves determined by transthoracic echocardiography was reduced significantly from 37.5 ± 15.3 mmHg in patients with prosthesis stenosis to 16.3 ± 8.2 mmHg (p < 0.001). In all cases with severe prosthesis regurgitation, regurgitation was reduced to none or mild. All-cause mortality after 30 days was 0%.

Conclusions: It was concluded that CoreValve Evolut R is well suited for ViV implantation.

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Keywords

aortic valve, transcatheter aortic valve implantation, valve-in-valve

About this article
Title

Valve in valve implantation of the CoreValve Evolut R in degenerated surgical aortic valves

Journal

Cardiology Journal

Issue

Vol 25, No 3 (2018)

Pages

301-307

Published online

2018-01-25

DOI

10.5603/CJ.a2018.0004

Pubmed

29570211

Bibliographic record

Cardiol J 2018;25(3):301-307.

Keywords

aortic valve
transcatheter aortic valve implantation
valve-in-valve

Authors

Marius Schwerg
Karl Stangl
Michael Laule
Verena Stangl
Henryk Dreger

References (10)
  1. Potter DD, Sundt TM, Zehr KJ, et al. Operative risk of reoperative aortic valve replacement. J Thorac Cardiovasc Surg. 2005; 129(1): 94–103.
  2. Eggebrecht H, Schäfer U, Treede H, et al. Valve-in-valve transcatheter aortic valve implantation for degenerated bioprosthetic heart valves. JACC Cardiovasc Interv. 2011; 4(11): 1218–1227.
  3. Khawaja MZ, Haworth P, Ghuran A, et al. Transcatheter aortic valve implantation for stenosed and regurgitant aortic valve bioprostheses CoreValve for failed bioprosthetic aortic valve replacements. J Am Coll Cardiol. 2010; 55(2): 97–101.
  4. Jategaonkar SR, Scholtz W, Horstkotte D, et al. Transfemoral aortic valve-in-valve implantation with the CoreValve Evolut for small degenerated stented bioprosthesis. J Invasive Cardiol. 2014; 26(6): 291–294.
  5. Diemert P, Seiffert M, Frerker C, et al. Valve-in-valve implantation of a novel and small self-expandable transcatheter heart valve in degenerated small surgical bioprostheses: the Hamburg experience. Catheter Cardiovasc Interv. 2014; 84(3): 486–493.
  6. Manoharan G, Walton AS, Brecker SJ, et al. Treatment of Symptomatic Severe Aortic Stenosis With a Novel Resheathable Supra-Annular Self-Expanding Transcatheter Aortic Valve System. JACC Cardiovasc Interv. 2015; 8(10): 1359–1367.
  7. Dvir D, Webb J, Brecker S, et al. Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry. Circulation. 2012; 126(19): 2335–2344.
  8. Dvir D, Barbanti M, Tan J, et al. Transcatheter aortic valve-in-valve implantation for patients with degenerative surgical bioprosthetic valves. Curr Probl Cardiol. 2014; 39(1): 7–27.
  9. Schwerg M, Fulde F, Dreger H, et al. Optimized Implantation Height of the Edwards SAPIEN 3 Valve to Minimize Pacemaker Implantation After TAVI. J Interv Cardiol. 2016; 29(4): 370–374.
  10. Simonato M, Azadani AN, Webb J, et al. In vitro evaluation of implantation depth in valve-in-valve using different transcatheter heart valves. EuroIntervention. 2016; 12(7): 909–917.

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