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Bioprosthetic Aortic Valve Degeneration After TAVR and SAVR: Incidence, Diagnosis, Predictors, and Management.
J Cardiovasc Dev Dis
November 2024
Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.
Bioprosthetic aortic valve degeneration (BAVD) is a significant clinical concern following both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). The increasing use of bioprosthetic valves in aortic valve replacement in younger patients and the subsequent rise in cases of BAVD are acknowledged in this review which aims to provide a comprehensive overview of the incidence, diagnosis, predictors, and management of BAVD. Based on a thorough review of the existing literature, this article provides an updated overview of the biological mechanisms underlying valve degeneration, including calcification, structural deterioration, and inflammatory processes and addresses the various risk factors contributing to BAVD, such as patient demographics, comorbidities, and procedural variables.
View Article and Find Full Text PDFAortic Valve-in-Valve Procedures: Challenges and Future Directions.
J Clin Med
August 2024
Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, 6 Avenue du Noyer Lambert, 91100 Massy, France.
Aortic valve-in-valve (ViV) procedures are increasingly performed for the treatment of surgical bioprosthetic valve failure in patients at intermediate to high surgical risk. Although ViV procedures offer indisputable benefits in terms of procedural time, in-hospital length of stay, and avoidance of surgical complications, they also present unique challenges. Growing awareness of the technical difficulties and potential threats associated with ViV procedures mandates careful preprocedural planning.
View Article and Find Full Text PDFPushing the hybrid approach to the edges, three stories in one: a case report.
Eur Heart J Case Rep
July 2024
Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Center, Singapore City, Singapore.
Background: Mitral annular calcification (MAC) is common in the elderly. Extensive calcification has been historically challenging for the cardiac surgeons, with traditional surgical approaches carrying significant risks. Less invasive approaches have recently been explored in an attempt to reduce this risk.
View Article and Find Full Text PDFOne-Year Outcomes of Transseptal Mitral Valve-in-Valve in Intermediate Surgical Risk Patients.
Circ Cardiovasc Interv
August 2024
Washington University, Barnes-Jewish Hospital, St. Louis, MO (T.K., A.Z.).
Article Synopsis
- Transcatheter mitral valve-in-valve replacement is a less invasive option for high-risk patients with failed bioprosthetic mitral valves, and this study focuses on its outcomes in intermediate-risk patients.
- A total of 50 patients, mostly around 70 years old, were treated using a balloon-expandable valve, and results showed no deaths or strokes within one year post-procedure.
- The procedure led to significant improvement in patients' symptoms and quality of life, with most experiencing low levels of mitral regurgitation and overall better heart function after one year.
Leaflet modification with the ShortCut™ device to prevent coronary artery obstruction during TAVR.
Cardiovasc Revasc Med
August 2024
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:
Article Synopsis
- Transcatheter heart valve (THV) procedures, particularly valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR), need careful planning to avoid life-threatening coronary artery obstruction (CAO).
- Despite using imaging and known predictors, predicting CAO remains uncertain.
- The ShortCut™ device is designed to modify heart valve leaflets during TAVR to reduce the risk of CAO, and this review discusses its objectives, design, procedures, clinical data, and future applications.
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