A 61-year-old female patient suffering from recent onset palpitations and dyspnea on exertion with hypertension and mitral valve prolapse in her past history came to our outpatient department. Echocardiography reveale...A 61-year-old female patient suffering from recent onset palpitations and dyspnea on exertion with hypertension and mitral valve prolapse in her past history came to our outpatient department. Echocardiography revealed a mild mitral valve prolapse, slightly decreased left ventricular （LV） function （LV ejection fraction： 51%） and a mild mitral regurgitation.展开更多
Objectives Transcatheter valve-in-valve （VIV） implantation for failed bioprostheses has become an alternative to open surgery in those deemed high risk. The purpose of this study was to evaluate the effectiveness an...Objectives Transcatheter valve-in-valve （VIV） implantation for failed bioprostheses has become an alternative to open surgery in those deemed high risk. The purpose of this study was to evaluate the effectiveness and outcomes of this emerging procedure. Methods Fourty VIV procedures were performed in 38 consecutive patients （mean age 70 ± 14 years and mean Logistic EuroScore 23.6 ± 15.5%） with severe aortic （n = 19） or mitral （n = 21） bioprosthetic valve dysfunction between 2014 and 2017. Bioprosthetic failure was secondary to stenosis in 11 （27.5%）, regurgitation in 19 （47.5%）, and combined in 10 （25.0%） bioprostheses. Clinical, echocardiographic, and procedural profiles were characterized, and the short-term results of the study patients were reported. Results Successful transfemoral （n = 15）, trans-subclavian （n = 1）, or transapical （n = 3） aortic VIV using either balloon-expandable valves （Edwards Sapien XT, n = 7） or self-expandable valves （Medtronic CoreValve, n = 12）; and transapical （n = 21） mitral VIV using either Edwards Sapien XT （n = 15） or me-chanically expandable valves （Boston Scientific Lotus, n = 6） were accomplished in all 40 VIV procedures. Implantation was successful with immediate restoration of satisfactory valve function in all patients. Five patients （13.2%） died at a median follow up of 9.3 months. Most of the 33 patients alive were in good functional status with good prosthetic valve performance. Conclusions Transcatheter VIV implantation is a feasible and safe option for the management of bioprosthetic valve failure. It may offer a less invasive alternative for those high-risk patients needing repeat valve replacement.展开更多
文摘A 61-year-old female patient suffering from recent onset palpitations and dyspnea on exertion with hypertension and mitral valve prolapse in her past history came to our outpatient department. Echocardiography revealed a mild mitral valve prolapse, slightly decreased left ventricular （LV） function （LV ejection fraction： 51%） and a mild mitral regurgitation.
文摘Objectives Transcatheter valve-in-valve （VIV） implantation for failed bioprostheses has become an alternative to open surgery in those deemed high risk. The purpose of this study was to evaluate the effectiveness and outcomes of this emerging procedure. Methods Fourty VIV procedures were performed in 38 consecutive patients （mean age 70 ± 14 years and mean Logistic EuroScore 23.6 ± 15.5%） with severe aortic （n = 19） or mitral （n = 21） bioprosthetic valve dysfunction between 2014 and 2017. Bioprosthetic failure was secondary to stenosis in 11 （27.5%）, regurgitation in 19 （47.5%）, and combined in 10 （25.0%） bioprostheses. Clinical, echocardiographic, and procedural profiles were characterized, and the short-term results of the study patients were reported. Results Successful transfemoral （n = 15）, trans-subclavian （n = 1）, or transapical （n = 3） aortic VIV using either balloon-expandable valves （Edwards Sapien XT, n = 7） or self-expandable valves （Medtronic CoreValve, n = 12）; and transapical （n = 21） mitral VIV using either Edwards Sapien XT （n = 15） or me-chanically expandable valves （Boston Scientific Lotus, n = 6） were accomplished in all 40 VIV procedures. Implantation was successful with immediate restoration of satisfactory valve function in all patients. Five patients （13.2%） died at a median follow up of 9.3 months. Most of the 33 patients alive were in good functional status with good prosthetic valve performance. Conclusions Transcatheter VIV implantation is a feasible and safe option for the management of bioprosthetic valve failure. It may offer a less invasive alternative for those high-risk patients needing repeat valve replacement.
