title: Valve-in-valve transcatheter aortic valve implantation overcoming hostile anatomy: Evolut R for the treatment of Mitroflow bioprosthesis dysfunction.
abstract: Redo surgery is regarded as the first-line treatment option for patients presenting with prosthetic valve degeneration. However, many patients have concomitant co-morbidities and this option is associated with significant risk. Transcatheter valve-in-valve implantation is an alternative strategy depending on the bioprosthetic valve that is being treated. The Sorin Mitroflow bioprosthetic aortic valve has been regarded as a contraindication to valve-in-valve treatment due to the high risk of coronary obstruction. We here present the case of a patient with small peripheral vasculature who underwent successful transfemoral valve-in-valve implantation and subsequently discuss the challenges and technical aspects that require consideration.
authors.affiliation: San Raffaele Scientific Institute, Milan, Italy.|Imperial College, London, UK.|EMO-GVM Centro Cuore Columbus, Via Buonarroti 48, 20145, Milan, Italy.
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.affiliation: San Raffaele Scientific Institute, Milan, Italy.|EMO-GVM Centro Cuore Columbus, Via Buonarroti 48, 20145, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: San Raffaele Scientific Institute, Milan, Italy. info@emocolumbus.it.|EMO-GVM Centro Cuore Columbus, Via Buonarroti 48, 20145, Milan, Italy. info@emocolumbus.it.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D061330:Multidetector Computed Tomography; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*
keywords: Coronary obstruction; Evolut R; Mitroflow; Transcatheter aortic valve implantation; Valve-in-valve