title: Transcatheter aortic and mitral valve implantations for failed bioprosthetic heart valves.
abstract: BACKGROUND
  Restoring degenerated bioprosthetic valves by transcatheter valve implantation may obviate the need for redo surgery in carefully selected patients. We present our initial experience with valve-in-valve (VIV) procedures for failed aortic and mitral bioprosthetic valves.
  
  
  METHODS
  Data were collected for all patients who underwent VIV procedures at a tertiary medical center (n = 6). Findings were analyzed and compared with those for transcatheter valve implantation in native valves at the same center during the last 3 years (n = 84).
  
  
  RESULTS
  Six patients of mean age 78.3 ± 13.8 years (range, 51-87) underwent VIV procedures with the CoreValve (n = 4) or Edwards-SAPIEN device (n = 2). Four (66%) had a failed prosthetic aortic valve, and 2 (33%) had a failed prosthetic mitral valve. Regurgitation accounted for valve failure in 83.3% of the VIV group versus 1.2% of the comparison group (p < 0.001). Procedural success and 30-day survival rates were 100%. Patient functional class improved significantly from 0% class I/II, 50% class III, and 50% class IV before the procedure to 66% class I, 33% class II, and 0% class III/IV after (p < 0.001).
  
  
  CONCLUSIONS
  This preliminary experience demonstrates that in carefully selected cases, transcathether valve implants can be safely and effectively deployed in stenotic and/or regurgitant degenerated bioprosthetic valves. Further evaluations in larger series are needed.
authors: Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel.
authors: Danny
authors: D
authors: Dvir
authors: Abid
authors: A
authors: Assali
authors: Hana
authors: H
authors: Vaknin-Assa
authors: Alexander
authors: A
authors: Sagie
authors: Yaron
authors: Y
authors: Shapira
authors: Eyal
authors: E
authors: Porat
authors: Ran
authors: R
authors: Kornowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D012008:Recurrence; D018709:Statistics, Nonparametric; D017211:Treatment Failure; D014481:United States