Methodist DeBakey cardiovascular journal
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Methodist Debakey Cardiovasc J · Jul 2017
ReviewTranscatheter Aortic Valve-in-Valve Procedure in Patients with Bioprosthetic Structural Valve Deterioration.
Surgical aortic valve replacement is the gold standard procedure to treat patients with severe, symptomatic aortic valve stenosis or insufficiency. Bioprosthetic valves are used for surgical aortic valve replacement with a much greater prevalence than mechanical valves. However, bioprosthetic valves may fail over time because of structural valve deterioration; this often requires intervention due to severe bioprosthetic valve stenosis or regurgitation or a combination of both. ⋯ Data from experimental studies and analyses of results from clinical procedures have led to strategies to improve outcomes of these procedures. The type, size, and implant position of the transcatheter valve can be optimized for individual patients with knowledge of detailed dimensions of the surgical valve and radiographic and echocardiographic measurements of the patient's anatomy. Understanding the complexities of the ViV procedure can lead surgeons to make choices during the original surgical valve implantation that can make a future ViV operation more technically feasible years before it is required.
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Methodist Debakey Cardiovasc J · Jul 2017
ReviewTranscatheter Valve Replacement: Risk Levels and Contemporary Outcomes.
Transcatheter aortic valve replacement (TAVR) has exploded into medical care for aortic stenosis, thus changing the treatment options for patients. TAVR is currently approved for extreme-risk, high-risk, and intermediate-risk patients with symptomatic severe aortic stenosis, and randomized trials for low-risk patients are underway. This article traces the trajectory of TAVR as a viable option for higher-risk patients and examines current outcomes.