Balloon fracturing valve-in-valve : how to do it and a case report of TAVR in a rapid deployment prosthesis

• Autor(a) principal: Saadi, Rodrigo Petersen
• Data de Publicação: 2022
• Outros Autores: Tagliari, Ana Paula, Polanczyk, Carisi Anne, Leal, João Carlos Ferreira, Saadi, Eduardo Keller
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/265611
• topic: Valva aórtica; Próteses valvulares cardíacas; Bioprótese; Resultado do tratamento

Transcatheter aortic valve replacement (TAVR) to treat degeneration of bioprosthetic heart valves (BHVs), called as valve-in-valve (ViV), is becoming a key feature since the number of BHVs requiring intervention is increasing and many patients are at high risk for a redo cardiac surgery. However, a TAVR inside a small previous cardiac valve may lead to prosthesis-patient mismatch (PPM) and not be as effective as we hoped for. An effective option to decrease the chance of PPM is to fracture the previous heart valve implanted using a high-pressure balloon. By performing a valve fracture, the inner valve ring of small BHVs can be opened up by a single fracture line, allowing subsequent implantation of a properly sized transcatheter heart valve, without increasing substantially the procedure risk. In this article, we provide a step-by-step procedure on how to safely and properly fracture a BHV and report a case of a TAVR in a degenerated rapid deployment valve.