Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Dec 2011
Performance of valve-in-valve for severe para-prosthetic leaks due to inadequate transcatheter aortic valve implantation.
This study reports on mid-term safety and performance of valve-in-valve implantation as rescue strategy to overcome acute PPL after TAVI. ⋯ Valve-in-valve implantation using self-expandable bioprosthesis seems safe and highly effective to overcome severe PPL due to prosthesis malposition early after TAVI. Moreover, the implantation of two valves does not affect the performance of prosthesis at follow-up.
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Catheter Cardiovasc Interv · Dec 2011
Transcatheter aortic valve implantation: lessons from the learning curve of the first 270 high-risk patients.
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving strategy for therapy of aortic stenosis. We describe the effect of the learning curve from the first 270 high-risk patients in Vancouver, Canada. ⋯ TAVI outcomes improve with experience and device development. While overall complication rates are low, scope remains to further reduce procedural adverse events.
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Catheter Cardiovasc Interv · Dec 2011
Transcatheter valve in valve implantation for failed mitral and tricuspid bioprosthesis.
We report our experience with the transapical transcatheter "Valve in valve" implantation (T-VIV) in patients with a failed mitral or tricuspid bioprosthesis; we briefly review the pertinent literature, and discuss some technical aspects of this procedure. ⋯ The results of T-VIV procedure in the mitral position have been suboptimal, and four of the sixteen patients reported to date died. However, all patients were extremely diseased, and some of the reported failures were related to amendable technical factors relative to the surgical access or to the valve deployment technique. With increasing experience, this procedure might become indicated as an alternative to conventional surgery in selected patients, encouraging increased use of bioprosthesis, and marking a pivotal change in the management of valvular disease.