Procedural complications: post implantation gradients

TAVI within failing surgical aortic bioprostheses

Transcatheter heart valve (THV) implantation for native valve aortic stenosis has evolved as a viable, less invasive alternative to open-heart surgery in selected patients. In these cases, mean transvalvular gradients average 5 to 15 mmHg. In contrast, mean transvalvular gradients following TAV-in-SAV are frequently higher in the range of 10 – 25 mmHg. Initially, for this reason, TAV-in-SAV cases did not meet the Valve Academic Research Consortium (VARC) definition for acute procedural success. Recently, with the development of a newer generation of devices, THV implantation within failed surgically implanted bioprostheses has proven to be feasible. In this section we look at the This section focuses our evolving knowledge concerning this issue.