14 May 2024
TAVI in TAVI - LIVE case
Balloon expandable valve in a self-expandable valve
Procedural Analyst:
D. Mylotte
Summary
A 74-year-old male with a history of cancer, TAVI with Evolut R 34 in 2019, COPD, obesity, and RBBB presents with a symptomatic degenerated valve (regurgitation).
It was decided to implant a Sapien 3 Ultra 26, without pre-dilatation and post-dilatation, using a temporary pacing lead (due to RBBB), via the right femoral approach with right radial as secondary access. The closure devices used were 1 ProGlide and 1 AngioSeal.
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LIVE Educational Case from University Medical Center, Mainz - Germany
Key moments
- 14:00-18:45 - Procedural analysis before the live case
- 20:11-22:42 - Procedural strategy
- 31:00-34:26 - Valve crossing with tips and tricks
- 37:07-43:20 - Valve implantation
- 58:54-01:04:05 - Procedural analysis after the live case
Keywords: TAVI in TAVI, Sapien 3 ultra, proglide pre and post-procedure, angioseal 8F, closure access
Learning Objectives
- To reflect on current indications of TAVI for degenerated bioprostheses including re-do TAVI
- To learn how to plan a re-do TAVI procedure?
- To appreciate how to optimise a valve-in-valve procedure with special regard to a re-do TAVI for a degenerated SE-Prosthesis
