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Redo TAVI: Improved Hemodynamics With a Supra-Annular Valve in a Small Annulus
Alok D Shah1, Anwar Hussain1, Andrew Wiper1
1Blackpool Teaching Hospitals NHS FT, Blackpool, United Kingdom.
Background:
Expanding transcatheter aortic valve implantation (TAVI) indications to include severe aortic stenosis patients at a younger age, combined with increasing patient survival, have led to a rise in Redo TAVI procedures. In them, patients with a small native annulus pose a unique challenge.
Case Summary:
We describe such a patient who presented with early transcatheter heart valve (THV) failure and underwent redo TAVI with an Allegra THV, with an emphasis on redo TAVI planning concepts & process.
Discussion:
The Allegra THV's distinctive design allows for higher effective orifice areas in small annuli while commissural post movement owing to a flexible outflow reduce leaflet stress.
Take-Home Messages:
Redo TAVI procedures require meticulous CT analysis for procedural and hemodynamic success. The Redo TAVI app by Dr Bapat is an essential aid, and the Allegra THV a useful consideration in redo TAVI procedures with small annuli.
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