Kardiologie up2date 2013; 09(04): 260-264
DOI: 10.1055/s-0033-1359039
Hotline – Herzklappenerkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

TAVI: Valve-in-Valve-Therapie

Stephan Haussig
,
Axel Linke
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Publikationsverlauf

Publikationsdatum:
14. Januar 2014 (online)

Abstract

Elderly, high-risk patients with failing bioprosthetic valves can be effectively and safely treated by transcatheter valve-in-valve implantation. This is independent of whether the primary mode of bioprosthetic valve failure was regurgitation, stenosis or a combination of both. If a transfemoral approach is chosen by the experienced heart team, the procedure can be carried out with conscious sedation in the absence of intubation and mechanical ventilation. The valve-in-valve procedure has a favourable outcome with an acceptable 30 days mortality and leads to an instantaneous and persistent improvement in hemodynamics. There is a lot of experience with valve-in-valve therapy in aortic valve bioprosthetic failure, but also the preliminary data regarding the valve-in-valve procedure in bioprosthetic valves in mitral, tricuspid and pulmonic position are rising the hope that also these patients might derive a benefit from this less invasive treatment option.

 
  • Literatur

  • 1 Iung B, Baron G, Butchart EG et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003; 24: 1231-1243
  • 2 Makkar RR, Fontana GP, Jilaihawi H. PARTNER Trial Investigators et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med 2012; 366: 1696-1704
  • 3 Kodali SK, Williams MR, Smith CR. PARTNER Trial Investigators et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med 2012; 366: 1686-1695
  • 4 Brown JM, O'Brien SM, Wu C et al. Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. J Thorac Cardiovasc Surg 2009; 137: 82-90
  • 5 Cohn LH, Collins JJ, Rizzo RJ et al. Twenty-year follow-up of the Hancock modified orifice porcine aortic valve. Ann Thorac Surg 1998; 66: 30-34
  • 6 Wenaweser P, Buellesfeld L, Gerckens U et al. Percutaneous aortic valve replacement for severe aortic regurgitation in degenerated bioprosthesis: the first valve in valve procedure using the Corevalve Revalving system. Catheter Cardiovasc Interv 2007; 70: 760-764
  • 7 Dvir D, Webb J, Brecker S et al. Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry. Circulation 2012; 126: 2335-2344
  • 8 Linke A, Woitek F, Merx MW et al. Valve-in-valve implantation of Medtronic CoreValve prosthesis in patients with failing bioprosthetic aortic valves. Circ Cardiovasc Interv 2012; 5: 689-697
  • 9 Cerillo AG, Chiaramonti F, Murzi M et al. Transcatheter valve in valve implantation for failed mitral and tricuspid bioprosthesis. Catheter Cardiovasc Interv 2011; 78: 987-995
  • 10 Glower DD, Landolfo KP, Cheruvu S et al. Determinants of 15-year outcome with 1,119 standard Carpentier-Edwards porcine valves. Ann Thorac Surg 1998; 66: 44-48