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Surgery from the future: Performing a safe valve-in-valve explantation
Igor Belluschi1, Paola Redaelli2, Giuseppe Iaci2
1Cardiac Surgery Department San Raffaele University Hospital Milan, Italy.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|May 28, 2020
Summary
As more young patients receive transcatheter aortic valve implantation, some will need later open-heart surgery. This video details the challenging surgical technique for explanting a transcatheter heart valve due to subacute thrombosis.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Transcatheter aortic valve implantation (TAVI) is increasingly used in younger, lower-risk patients.
- A growing number of TAVI recipients may require future open-heart surgery for valve-related complications.
- Late explantation of transcatheter heart valves is rare and technically demanding.
Observation:
- This tutorial presents a case of subacute thrombosis in a valve-in-valve transcatheter aortic valve.
- The patient required surgical explantation of the malfunctioning transcatheter heart valve.
Findings:
- The video demonstrates a specific surgical technique for explanting a transcatheter heart valve without aortic root replacement.
- Successful valve explantation was achieved in the presented case.
Implications:
- This procedure highlights the feasibility of late transcatheter heart valve explantation in select cases.
- The described technique may offer a solution for managing rare but complex TAVI complications.
- Further research into managing long-term TAVI complications is warranted.
