Related Experiment Video
Updated: May 24, 2026

Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Pulmonary valve-in-valve implants: how long do they prolong reintervention and what causes them to fail?
Kelsey B Law1, Katharine R B Phillips, Jagdish Butany
1Department of Pathology, Toronto General Hospital/University Health Network, Toronto, Canada M5G 2C4.
Background:
The valve-in-valve (VinV) procedure is a minimally invasive, transcatheter, off-pump, alternative to conventional valve replacement, which uses a failing bioprosthesis to anchor a second transcatheter-delivered prosthesis. This technique appears effective for prolonging freedom from reintervention and treating early device failure. However, it is unknown as to how long reintervention can be avoided.
Methods:
We present the pathological findings of a VinV explanted after 47 months, as well as the failure modes of these devices.
Results:
The VinV approach in our case ultimately failed, likely due to the proximity of the host's tissues to the prosthetic device, resulting in a combination of pannus, calcification, and a cusp tear.
Conclusions:
Additional long-term follow-up of pulmonary VinV implantations is needed in order to determine the life span of VinVs and what causes them to fail.
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