Self-expandable valve-in-valve treatment for failing sutureless aortic bioprosthesis

J Card Surg. 2020 Feb;35(2):477-479. doi: 10.1111/jocs.14365. Epub 2019 Nov 25.

Abstract

Aortic valve replacement still represents the gold standard treatment for severe symptomatic aortic stenosis. Sutureless bioprostheses have been so far developed to enhance the minimally invasive approach, resulting in a reduction of cross-clamp time. Even if the first implantation was carried out more than 10 years ago, some cases of valve degeneration treated with balloon-expandable valve-in-valve procedures have been previously described in the literature. Here, we present a case of early sutureless valve degeneration resulting in severe aortic regurgitation. After careful evaluation of the patient's comorbidities, a successful valve-in-valve was finally performed using a self-expandable transcatheter prosthesis. A wide discussion of the Heart Team decision-making process and of the technical aspects has been addressed.

Keywords: SAVR; TAVI; sutureless; valve-in-valve.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / surgery*
  • Bioprosthesis*
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures / methods*
  • Prosthesis Failure*
  • Severity of Illness Index
  • Sutureless Surgical Procedures / adverse effects*
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome