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Updated: Dec 29, 2025

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
How Should I Manage a Challenging Aortic Prosthesis Angle During Valve-in-Valve Implantation?
Michael Bianco1, Abdul Rahman Omer1, Felice Reitknecht1
1Division of Cardiovascular Medicine Robert Packer Hospital, United States of America.
Abstract:
Valve-in-valve TAVR procedure stalled due to challenging aortic to prosthesis angle not allowing the advancement of the Evolut R into the failing 25 mm Magna prosthesis. Efforts to better align the TAVR device with the valve prosthesis by using conventional methods failed. Eventually, a buddy wire allowed advancement and successful deployment of the Evolut R 26 mm within the stenosed surgical valve. The role and methodology of buddy wire use in TAVR, valve-in-valve procedures (first report) and structural heart procedures is reviewed.
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