TRANSCATHETER VALVE-IN-VALVE IMPLANTATION FOR DEGENERATED BIOPROSTHETIC AORTIC AND MITRAL VALVES – AN UPDATE ON INDICATIONS, TECHNIQUES AND CLINICAL RESULTS

Abstract

ABSTRACT Introduction Aortic and mitral bioprosthesis are the gold standard treatment to replace a pathological native valve. However, bioprostheses are prone to structural valve degeneration, resulting in limited long-term durability. During the past decade, the implantation of transcatheter stent-valves within degenerated aortic and mitral bioprostheses, (the so-called “valve-in-valve” procedure), represent a valid alternative to redo surgery in patients with high-risk surgical profiles. Areas covered We reviewed the clinical outcomes and the procedural details of transcatheter aortic and mitral valve-in-valve series according to current published literature and include a practical guide for valve sizing and stent-valve positioning and strategies to prevent complications. Expert opinion In both aortic and mitral positions meticulous planning is fundamental in these procedures to avoid serious complications including patient prosthesis mismatch, coronary obstruction and left ventricular outflow tract obstruction.