title: First Lotus aortic valve-in-valve implantation to treat degenerated Mitroflow bioprostheses.
abstract: OBJECTIVE
  Transcatheter aortic valve-in-valve implantation is an emerging alternative to conventional surgical aortic valve replacement (SAVR) in patients with degenerated aortic bioprostheses. This procedure presents a high risk of coronary occlusion, especially during treatment of patients implanted with a bioprosthesis with a lower distance between the leaflets and the coronary ostia, such as the Mitroflow valve (Sorin S.p.A., Milan, Italy). In this report we aim to describe the safety and feasibility of transfemoral valve-in-valve implantation of a new-generation Lotus™ Aortic Valve Replacement System (Boston Scientific, Marlborough, MA, USA) in a case of degenerated Mitroflow bioprostheses.
  
  
  RESULTS
  We describe a case of degenerated Sorin Mitroflow bioprostheses successfully treated with the transfemoral new-generation Lotus valve-in-valve system. During the procedure no coronary protection was required and the patient had no MACE at 30-day follow-up. To our knowledge, this is the first report of a Lotus valve implant in a degenerated Mitroflow prosthesis.
  
  
  CONCLUSIONS
  The transcatheter valve-in-valve procedure using the new-generation Lotus Valve System is a safe and feasible alternative to repeat cardiac surgery in high-risk patients with surgical degenerated Mitroflow bioprostheses.
authors.affiliation: Cardiovascular Unit, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Castriota
authors.forename: Caterina
authors.initials: C
authors.lastname: Cavazza
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
authors.forename: Antonio
authors.initials: A
authors.lastname: Micari
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D054059:Coronary Occlusion / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods; D016896:Treatment Outcome