09 Feb 2025
Valve in valve in small degenerative surgical bioprosthesis - LIVE case
Valve in valve with a fracture of the degenerative surgical bioprosthesis valve
Summary
A 74-year-old female with a permanent pacemaker and preserved LV function presented with a symptomatic degenerative surgical valve (SJ Epic 21) implanted in 2016.
Patient underwent implantation of an Evolut FX 26 mm under general anesthesia with cerebral embolic protection and TEE guidance. A surgical valve fracture was performed before TAVI implantation, followed by post-dilatation.
LIVE Educational Case from Cheng Hsin General Hospital - Taipei City, Taiwan
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Key moments
- 03:54–07:10 - Imaging analysis
- 19:31–24:12 - TEE analysis before the valve crossing
- 30:30–32:48 - Surgical valve fracture
- 32:56–40:17 - Valve deployment with 3 recaptures
- 52:30–57:40 - Procedural analysis
Keywords: Valve in valve, fracture surgical valve, Sentinel, Evolut FX, closure access, post dilatation
Learning Objectives
- To approach the inherent risks of TAVI for small failed surgical aortic valves
- To understand contemporary techniques to optimise the outcomes of TAVI for small failed surgical aortic valves
- To capture the procedural challenges of valve-in-valve
