Transcatheter valve-in-valve aortic valve replacement for degenerated aortic surgical bioprostheses:A retrospective study in a single center
Objective To summarize the results and clinical experience of transcatheter valve-in-valve implantation using domestic self-expanding valve in patients with aortic degenerated bio-prosthesis.Methods From January 2019 to April 2023,the patients who underwent transcatheter valve-in-valve surgery in the Department of Cardiac Surgery of Tianjin Chest Hospital due to surgical bio-prosthesis failure were included.Characteristics of valves,perioperative complications,and hemodynamic manifestations during the early postoperative and follow-up period were analyzed.Results A total of 24 patients were enrolled,including 14 males and 10 females with an average age of 68.17±7.72 years,and the average interval between the two operations was 10.48±4.09 years.All patients were successfully discharged without complications such as coronary artery obstruction and pacemaker implantation,and the average transvalvular pressure gradient was 16.39±6.52 mm Hg before discharge.During the median follow-up time of 16 months,the left ventricular diastolic inner diameter and ejection fraction were continuously improved.Conclusion Trans-catheter valve-in-valve using domestic self-expanding valves is safe and feasible to treat aortic bioprosthetic valve failure.Sound patient selection and surgical strategies are critical to achieve good hemodynamics.
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