Interventional options for severe aortic regurgitation after transcatheter aortic valve implantation: balloons, snares, valve-in-valve

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Reference

  1. 1.

    Leon MB, Smith CR, Mack M et al (2010) Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 363:1597–1607

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Smith CR, Leon MB, Mack MJ et al (2011) Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 364:2187–2198

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Abdel-Wahab M, Zahn R, Horack M et al (2011) Aortic regurgitation after transcatheter aortic valve implantation: incidence and early outcome. Results from the German transcatheter aortic valve interventions registry. Heart 97:899–906

    PubMed  Article  Google Scholar 

  4. 4.

    Ussia GP, Barbanti M, Ramondo A et al (2011) The valve-in-valve technique for treatment of aortic bioprosthesis malposition an analysis of incidence and 1-year clinical outcomes from the Italian CoreValve registry. J Am Coll Cardiol 57:1062–1068

    PubMed  Article  Google Scholar 

  5. 5.

    Piazza N, Schultz C, de Jaegere PP, Serruys PW (2009) Implantation of two self-expanding aortic bioprosthetic valves during the same procedure-insights into valve-in-valve implantation (“Russian doll concept”). Catheter Cardiovasc Interv 73:530–539

    PubMed  Article  Google Scholar 

  6. 6.

    Ussia GP, Mule M, Tamburino C (2009) The valve-in-valve technique: transcatheter treatment of aortic bioprothesis malposition. Catheter Cardiovasc Interv 73:713–716

    PubMed  Article  Google Scholar 

  7. 7.

    Zahn R, Schiele R, Kilkowski C, Zeymer U (2010) Severe aortic regurgitation after percutaneous transcatheter aortic valve implantation: on the importance to clarify the underlying pathophysiology. Clin Res Cardiol 99:193–197

    PubMed  Article  Google Scholar 

  8. 8.

    Vavuranakis M, Vrachatis D, Stefanadis C (2010) CoreValve aortic bioprosthesis: repositioning techniques. JACC Cardiovasc Interv 3:565–566

    PubMed  Article  Google Scholar 

  9. 9.

    Majunke N, Doss M, Steinberg DH et al (2010) How should I treat a misplaced self-expanding aortic bioprosthetic valve? EuroIntervention 6:537–542

    PubMed  Article  Google Scholar 

  10. 10.

    Zahn R, Schiele R, Kilkowski C et al (2011) Correction of aortic regurgitation after transcatheter aortic valve implantation of the Medtronic CoreValveTM prosthesis due to a too-low implantation, using transcatheter repositioning. J Heart Valve Dis 20:64–69

    PubMed  Google Scholar 

  11. 11.

    Ruiz CE, Laborde JC, Condado JF, Chiam PT, Condado JA (2008) First percutaneous transcatheter aortic valve-in-valve implant with three year follow-up. Catheter Cardiovasc Interv 72:143–148

    PubMed  Article  Google Scholar 

  12. 12.

    Kempfert J, Rastan AJ, Schuler G et al (2011) A second prosthesis as a procedural rescue option in trans-apical aortic valve implantation. Eur J Cardiothorac Surg 40:56–60

    PubMed  Article  Google Scholar 

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Conflict of interest

Holger Eggebrecht is a trainer for transcatheter aortic valve implantation (TAVI) for Medtronic/CoreValve and clinical proctor for Edwards Lifesciences. Mirko Doss is a clinical proctor for Edwards Lifesciences.

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Correspondence to Holger Eggebrecht.

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392_2012_434_MOESM1_ESM.avi

Movie 1. Angiography after valve implantation showing a too-low position of the prosthesis into the left ventricular outflow tract, resulting in severe paravalvular regurgitation. (AVI 9126 kb)

392_2012_434_MOESM2_ESM.avi

Movie 2. Upwards pulling of the prosthesis by a loop snare attached to one of the frame loops resulting in an optimal position with diminished regurgitation. After release of tension, the valve migrates back into the too-low position (AVI 4458 kb)

392_2012_434_MOESM3_ESM.avi

Movie 3. Balloon dilatation of the implanted valve. (AVI 10611 kb)

Movie 4. Stepwise implantation of the second (valve-in-valve) Medtronic/CoreValve prosthesis at a higher position. (WMV 7950 kb)

392_2012_434_MOESM5_ESM.avi

Movie 5. Final result showing only trace transvalvular regurgitation. (AVI 6014 kb)

Movie 1. Angiography after valve implantation showing a too-low position of the prosthesis into the left ventricular outflow tract, resulting in severe paravalvular regurgitation. (AVI 9126 kb)

Movie 2. Upwards pulling of the prosthesis by a loop snare attached to one of the frame loops resulting in an optimal position with diminished regurgitation. After release of tension, the valve migrates back into the too-low position (AVI 4458 kb)

Movie 3. Balloon dilatation of the implanted valve. (AVI 10611 kb)

Movie 5. Final result showing only trace transvalvular regurgitation. (AVI 6014 kb)

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Eggebrecht, H., Doss, M., Schmermund, A. et al. Interventional options for severe aortic regurgitation after transcatheter aortic valve implantation: balloons, snares, valve-in-valve. Clin Res Cardiol 101, 503–507 (2012). https://doi.org/10.1007/s00392-012-0434-4

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Keywords

  • Aortic Regurgitation
  • Transcatheter Aortic Valve Implantation
  • Left Ventricular Outflow Tract
  • Aortic Annulus
  • Paravalvular Leakage