17 May 2023
Valve-in-valve - LIVE case
Self-expandable valve-in-valve with surgical valve ring fracture (mismatch)
Summary
Study the case of a 76-year-old female patient with BMI 32, atrial fibrillation, diabetes, mid chronic kidney disease and history of aortic stenosis, whose Perimount Magna Ease 21 (mismatch) surgical bioprosthesis, implanted in 2016, degenerated, with preserved left ventricular function.
An Evolut Pro 26 was implanted in rapid pacing, with a temporary pacemaker lead without predilatation. Due to the mismatch, post-dilation was performed to achieve surgical ring fracture.
Follow the step-by-step analysis of this deployment, with emphasis on procedural analysis.
LIVE Case from Heart Centre, Leipzig - Germany
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Key moments
- 25:53 - 35:20 - Valve deployment
- 40:00 - 44:18 - Surgical valve fracture
- 56:59 - 01:01:09 - Procedural analysis
Key words: Valve-in-valve, Evolut Pro 26, Surgical valve ring fracture
Learning Objectives
- To reflect on current indications of TAVI for degenerated bioprosthesis
- To learn how to optimise strategy for failed small aortic bioprosthesis
- To appreciate how to optimise haemodynamics through transcatheter heart valve selection and implantation technique
