Balloon Fracturing Valve-in-Valve: How to Do It and a Case Report of TAVR in a Rapid Deployment Prosthesis.
Rodrigo Petersen SaadiAna Paula TagliariCarisi Anne PolanczyckJoão Carlos Ferreira LealEduardo Keller SaadiPublished in: Journal of interventional cardiology (2022)
Transcatheter aortic valve replacement (TAVR) to treat degeneration of bioprosthetic heart valves (BHVs), called as valve-in-valve (ViV), is becoming a key feature since the number of BHVs requiring intervention is increasing and many patients are at high risk for a redo cardiac surgery. However, a TAVR inside a small previous cardiac valve may lead to prosthesis-patient mismatch (PPM) and not be as effective as we hoped for. An effective option to decrease the chance of PPM is to fracture the previous heart valve implanted using a high-pressure balloon. By performing a valve fracture, the inner valve ring of small BHVs can be opened up by a single fracture line, allowing subsequent implantation of a properly sized transcatheter heart valve, without increasing substantially the procedure risk. In this article, we provide a step-by-step procedure on how to safely and properly fracture a BHV and report a case of a TAVR in a degenerated rapid deployment valve.
Keyphrases
- aortic valve
- transcatheter aortic valve replacement
- aortic stenosis
- aortic valve replacement
- ejection fraction
- transcatheter aortic valve implantation
- mitral valve
- left ventricular
- heart failure
- cardiac surgery
- randomized controlled trial
- chronic kidney disease
- end stage renal disease
- machine learning
- atrial fibrillation
- coronary artery disease
- newly diagnosed
- peritoneal dialysis
- quantum dots
- loop mediated isothermal amplification