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Matryoshka procedure for Valve-in-Valve TAVI failure
Vittoria Lodo1, Mauro De Benedictis2, Innocenzo Scrocca2
1Division of Cardiac Surgery Azienda Ospedaliera Ordine Mauriziano di Torino Turin Italy.
Clinical Case Reports
|February 11, 2022
Summary
Valve-in-valve transcatheter valve implantation (ViV-TAVI) is a treatment for high-risk patients with deteriorated bioprosthetic valves. This case highlights a salvage procedure for acute ViV-TAVI failure due to bioprosthetic sewing ring interference.
Area of Science:
- Cardiology
- Interventional Cardiology
- Bioprosthetic Heart Valves
Background:
- Valve-in-valve transcatheter valve implantation (ViV-TAVI) is a recognized treatment for degenerated bioprosthetic valves in high-risk surgical candidates.
- A challenge in ViV-TAVI is the potential for the existing bioprosthesis's fixed sewing ring to impede the proper expansion of the new transcatheter valve.
Observation:
- A case of acute failure following a ViV-TAVI procedure is presented.
- The failure was attributed to the mechanical obstruction caused by the sewing ring of the original bioprosthesis, hindering complete TAVI expansion.
Findings:
- The study details a successful salvage procedure for acute ViV-TAVI failure.
- This salvage intervention addressed the specific complication of inadequate TAVI expansion due to the bioprosthetic sewing ring.
Implications:
- This case underscores the importance of recognizing and managing potential complications related to bioprosthetic sewing rings during ViV-TAVI.
- Salvage strategies are crucial for improving outcomes in acute ViV-TAVI failure, particularly in complex cases involving anatomical challenges.
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