title: Bioprosthetic Aortic Paravalvular Leak: Is Valve-in-Valve Another Solution?
abstract: Paravalvular leak (PVL) following aortic valve implantation is a rare complication but may cause potentially serious consequences. It occurs in 2%-10% of surgical aortic valve replacements and 7%-17% of surgical mitral valve replacements. Transcatheter valve replacement data show that significant PVL occurs in 6%-8% of cases. The management of significant PVL has traditionally involved repeat surgical repair. However, many of these patients are considered too high risk to undergo a repeat surgical procedure; hence, a percutaneous transcatheter approach has often been utilized to treat these patients. Vascular plugs have been used to close PVLs, with variable results; the procedure is complex and technically demanding. Transcatheter aortic valve replacement, using a valve-in-valve approach, may provide an alternative approach for bioprosthetic PVL in the aortic position.
authors.affiliation: Division of Cardiovascular Medicine, University of Utah School of Medicine, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132 USA. anwar.tandar@hsc.utah.edu.
authors.forename: Anwar
authors.initials: A
authors.lastname: Tandar
authors.forename: David A
authors.initials: DA
authors.lastname: Bull
authors.forename: Frederick G P
authors.initials: FG
authors.lastname: Welt
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D004452:Echocardiography; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D012086:Reoperation; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects