Short-term results of valve-in-valve transcatheter aortic valve implantation in patients with degenerated bioprosthesis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HAN Xu , YANG Linjie , HUANG Chen , ZHU Xiaohua , HUANG Gongcheng ,  XU Jing

Department of Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, P. R. China;

Corresponding author：

XU Jing, Email: fccxuj@zzu.edu.cn

Keywords：

Valve-in-valve transcatheter aortic valve implantation; aortic valve replacement; bioprosthetic valve failure

DOI：

10.7507/1007-4848.202304058

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Objective To summarize the short-term results of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) in the treatment of bioprosthetic valve failure after aortic valve replacement. Methods We reviewed the clinical data of patients who underwent ViV-TAVI from 2021 to 2022 in the First Affiliated Hospital of Zhengzhou University. The valve function was evaluated by echocardiography before operation, immediately after operation and 3 months after operation. The all-cause death and main complications during hospitalization were analyzed. Results A total of 13 patients were enrolled, including 8 males and 5 females with a mean age of (65.9±8.5) years, and the interval time between aortic valve replacement and ViV-TAVI was (8.5±3.4) years. The Society of Thoracic Surgeons mortality risk score was 10.3%±3.2%. None of the 13 patients had abnormal valve function after operation. The mean transvalvular pressure gradient of aortic valve was decreased (P<0.001), the peak flow velocity of aortic valve was decreased (P<0.001), and the left ventricular ejection fraction was not changed significantly (P=0.480). There were slight perivalvular leakage in 2 patients and slight valve regurgitation in 3 patients. Three months after operation, the mean transvalvular pressure difference and peak flow velocity of aortic valve in 12 patients were significantly decreased compared with those before operation (P≤0.001). Conclusion This study demonstrates that ViV-TAVI for the treatment of bioprosthetic valve failure after aortic valve replacement is associated with favorable clinical and functional cardiovascular benefits, the short-term results are satisfactory.

Citation： HAN Xu, YANG Linjie, HUANG Chen, ZHU Xiaohua, HUANG Gongcheng, XU Jing. Short-term results of valve-in-valve transcatheter aortic valve implantation in patients with degenerated bioprosthesis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(7): 977-982. doi: 10.7507/1007-4848.202304058 Copy

1.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation, 2002, 106(24): 3006-3008.
2.	Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): 450-500.
3.	Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: A patient level multi-center analysis. Int J Cardiol, 2015, 189: 282-288.
4.	Dvir D, Webb JG, Bleiziffer S, et al. Transcatheter aortic valve implantation in failed bioprosthetic surgical valves. JAMA, 2014, 312(2): 162-170.
5.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Rev Esp Cardiol (Engl Ed), 2022, 75(6): 524.
6.	Nalluri N, Atti V, Munir AB, et al. Valve in valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-Surgical aortic valve replacement (redo-SAVR): A systematic review and meta-analysis. J Interv Cardiol, 2018, 31(5): 661-671.
7.	Malik AH, Yandrapalli S, Zaid S, et al. Valve-in-valve transcatheter implantation versus redo surgical aortic valve replacement. Am J Cardiol, 2020, 125(9): 1378-1384.
8.	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(5): 760-764.
9.	Bruno F, Elia E, D'Ascenzo F, et al. Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: A systematic review and meta-analysis of short and midterm results. Catheter Cardiovasc Interv, 2022, 100(1): 122-130.
10.	Jakobsen L, Terkelsen CJ, Søndergaard L, et al. Short- and long-term mortality and stroke risk after transcatheter aortic valve implantation. Am J Cardiol, 2018, 121(1): 78-85.
11.	Bajrangee A, Coughlan JJ, Teehan S, et al. Early and mid-term outcomes after transcatheter aortic valve implantation (TAVI) in Ireland. Int J Cardiol Heart Vasc, 2017, 16: 1-3.
12.	D'Errigo P, Moretti C, D'Ascenzo F, et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis in patients with chronic kidney disease stages 3b to 5. Ann Thorac Surg, 2016, 102(2): 540-547.
13.	Silaschi M, Wendler O, Seiffert M, et al. Transcatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses. Interact Cardiovasc Thorac Surg, 2017, 24(1): 63-70.
14.	Saji M, Higuchi R, Izumi Y, et al. Transcatheter aortic valve replacement in patients with extremely severe aortic stenosis. Int J Cardiol, 2021, 329: 162-166.
15.	Webb JG, Dvir D. Transcatheter aortic valve replacement for bioprosthetic aortic valve failure: The valve-in-valve procedure. Circulation, 2013, 127(25): 2542-2550.
16.	Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: Insights from the VIVID registry. Eur Heart J, 2018, 39(8): 687-695.
17.	Bernardi FLM, Dvir D, Rodes-Cabau J, et al. Valve-in-valve challenges: How to avoid coronary obstruction. Front Cardiovasc Med, 2019, 6: 120.
18.	Costa G, Criscione E, Todaro D, et al. Long-term transcatheter aortic valve durability. Interv Cardiol, 2019, 14(2): 62-69.
19.	Marin F, Scarsini R, Kotronias RA, et al. Aortic valve disease and associated complex CAD: The interventional approach. J Clin Med, 2021, 10(5): 946.
20.	Dziewierz A. The time is always right to do what is right: TAVI and timing of PCI. Int J Cardiol, 2023, 371: 128-129.
21.	Çelik M, Durko AP, Head SJ, et al. Coronary revascularization after surgical aortic valve replacement. JTCVS Open, 2020, 3: 91-101.
22.	Lim Y, Tan KA, Kuntjoro I, et al. Coronary artery disease in patients undergoing transvalvular aortic valve implantation. Interv Cardiol, 2022, 17: e13.
23.	Goel SS, Ige M, Tuzcu EM, et al. Severe aortic stenosis and coronary artery disease: Implications for management in the transcatheter aortic valve replacement era: A comprehensive review. J Am Coll Cardiol, 2013, 62(1): 1-10.
24.	Venturi G, Pighi M, Pesarini G, et al. Contrast-induced acute kidney injury in patients undergoing TAVI compared with coronary interventions. J Am Heart Assoc, 2020, 9(16): e017194.
25.	Ochiai T, Yoon SH, Flint N, et al. Timing and outcomes of percutaneous coronary intervention in patients who underwent transcatheter aortic valve implantation. Am J Cardiol, 2020, 125(9): 1361-1368.

1. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation, 2002, 106(24): 3006-3008.
2. Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): 450-500.
3. Yousef A, Simard T, Webb J, et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve: A patient level multi-center analysis. Int J Cardiol, 2015, 189: 282-288.
4. Dvir D, Webb JG, Bleiziffer S, et al. Transcatheter aortic valve implantation in failed bioprosthetic surgical valves. JAMA, 2014, 312(2): 162-170.
5. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Rev Esp Cardiol (Engl Ed), 2022, 75(6): 524.
6. Nalluri N, Atti V, Munir AB, et al. Valve in valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-Surgical aortic valve replacement (redo-SAVR): A systematic review and meta-analysis. J Interv Cardiol, 2018, 31(5): 661-671.
7. Malik AH, Yandrapalli S, Zaid S, et al. Valve-in-valve transcatheter implantation versus redo surgical aortic valve replacement. Am J Cardiol, 2020, 125(9): 1378-1384.
8. 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(5): 760-764.
9. Bruno F, Elia E, D'Ascenzo F, et al. Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: A systematic review and meta-analysis of short and midterm results. Catheter Cardiovasc Interv, 2022, 100(1): 122-130.
10. Jakobsen L, Terkelsen CJ, Søndergaard L, et al. Short- and long-term mortality and stroke risk after transcatheter aortic valve implantation. Am J Cardiol, 2018, 121(1): 78-85.
11. Bajrangee A, Coughlan JJ, Teehan S, et al. Early and mid-term outcomes after transcatheter aortic valve implantation (TAVI) in Ireland. Int J Cardiol Heart Vasc, 2017, 16: 1-3.
12. D'Errigo P, Moretti C, D'Ascenzo F, et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis in patients with chronic kidney disease stages 3b to 5. Ann Thorac Surg, 2016, 102(2): 540-547.
13. Silaschi M, Wendler O, Seiffert M, et al. Transcatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses. Interact Cardiovasc Thorac Surg, 2017, 24(1): 63-70.
14. Saji M, Higuchi R, Izumi Y, et al. Transcatheter aortic valve replacement in patients with extremely severe aortic stenosis. Int J Cardiol, 2021, 329: 162-166.
15. Webb JG, Dvir D. Transcatheter aortic valve replacement for bioprosthetic aortic valve failure: The valve-in-valve procedure. Circulation, 2013, 127(25): 2542-2550.
16. Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: Insights from the VIVID registry. Eur Heart J, 2018, 39(8): 687-695.
17. Bernardi FLM, Dvir D, Rodes-Cabau J, et al. Valve-in-valve challenges: How to avoid coronary obstruction. Front Cardiovasc Med, 2019, 6: 120.
18. Costa G, Criscione E, Todaro D, et al. Long-term transcatheter aortic valve durability. Interv Cardiol, 2019, 14(2): 62-69.
19. Marin F, Scarsini R, Kotronias RA, et al. Aortic valve disease and associated complex CAD: The interventional approach. J Clin Med, 2021, 10(5): 946.
20. Dziewierz A. The time is always right to do what is right: TAVI and timing of PCI. Int J Cardiol, 2023, 371: 128-129.
21. Çelik M, Durko AP, Head SJ, et al. Coronary revascularization after surgical aortic valve replacement. JTCVS Open, 2020, 3: 91-101.
22. Lim Y, Tan KA, Kuntjoro I, et al. Coronary artery disease in patients undergoing transvalvular aortic valve implantation. Interv Cardiol, 2022, 17: e13.
23. Goel SS, Ige M, Tuzcu EM, et al. Severe aortic stenosis and coronary artery disease: Implications for management in the transcatheter aortic valve replacement era: A comprehensive review. J Am Coll Cardiol, 2013, 62(1): 1-10.
24. Venturi G, Pighi M, Pesarini G, et al. Contrast-induced acute kidney injury in patients undergoing TAVI compared with coronary interventions. J Am Heart Assoc, 2020, 9(16): e017194.
25. Ochiai T, Yoon SH, Flint N, et al. Timing and outcomes of percutaneous coronary intervention in patients who underwent transcatheter aortic valve implantation. Am J Cardiol, 2020, 125(9): 1361-1368.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term results of valve-in-valve transcatheter aortic valve implantation in patients with degenerated bioprosthesis

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