Procedural complications: Transcatheter heart valves (THV) malposition

TAVI within failing surgical aortic bioprostheses

Correct positioning of transcatheter heart valves (THV) is always critical and the incidence of malposition in valve-in-valve interventions has been cited as being greater than 15%. Increased experience, more in-depth knowledge of the modalities of failure including considerations of the size of the failed valve and higher post-implantation gradients have helped to achieve better results. Today, developments in the THVs, the choice of the valve, the nature of its radiopacity, all are equally involved in the complexity leading to the success of the intervention. This section examines the different parameters involved in meeting the challenge of malposition.