Transapical transcatheter aortic valve-in-valve implantation: Clinical and hemodynamic outcomes beyond 2 years Jian Ye, MD, FRCSC, John G. Webb, MD,

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Presentation transcript:

Transapical transcatheter aortic valve-in-valve implantation: Clinical and hemodynamic outcomes beyond 2 years Jian Ye, MD, FRCSC, John G. Webb, MD, Anson Cheung, MD, Jia Lin Soon, MD, David Wood, MD, Christopher R. Thompson, MD, Brad Munt, MD, Robert Moss, MD, Samuel V. Lichtenstein, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 6, Pages 1554-1562 (June 2013) DOI: 10.1016/j.jtcvs.2012.05.016 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Balloon-expandable transcatheter bioprostheses and in vitro tests of valve-in-valve implantation. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Transapical valve-in-valve implantation of a balloon-expandable transcatheter valve within a failed surgically implanted Edwards aortic bioprosthesis with a metal frame at the base. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Transapical valve-in-valve implantation of a balloon-expandable transcatheter valve within a failed surgically implanted Medtronic Mosaic bioprosthesis without a metal frame at the base. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Left main obstruction after transapical valve-in-valve implantation into a failed Sorin Mitroflow aortic tissue valve. A, Small aortic root (a very “flat” sinus of Valsalva), a tightly fitted surgical valve, and low location of the left main ostium. B, Left main obstruction. LM, Left main (artery); THV, transcatheter heart value. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Echocardiographic follow-up on the aortic valve area and mean pressure gradient of Edwards SAPIEN valves implanted into failed surgical bioprostheses. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Appropriate positioning of a transcatheter valve within a surgical valve as determined by fluoroscopy or echocardiography. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 1554-1562DOI: (10.1016/j.jtcvs.2012.05.016) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions