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Use of balloon expandable transcatheter valves for valve-in-valve implantation in patients with degenerative stentless aortic bioprostheses: Technical.

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Presentation on theme: "Use of balloon expandable transcatheter valves for valve-in-valve implantation in patients with degenerative stentless aortic bioprostheses: Technical."— Presentation transcript:

1 Use of balloon expandable transcatheter valves for valve-in-valve implantation in patients with degenerative stentless aortic bioprostheses: Technical considerations and results  Vinayak Bapat, FRCS, CTh, William Davies, FRCP, Rizwan Attia, MRCS, Jane Hancock, FRCP, Kirsty Bolter, MSc, Christopher Young, FRCS, CTh, Simon Redwood, FRCP, Martyn Thomas, FRCP  The Journal of Thoracic and Cardiovascular Surgery  Volume 148, Issue 3, Pages (September 2014) DOI: /j.jtcvs Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 SAPIEN valve implantation in stentless valve. White line indicates the annular plane. A, A guide wire was placed in the left main artery (black arrow) to provide a landmark and can provide access to the left main artery. B, Postimplant aortogram after SAPIEN XT implantation. C, SAPIEN valve implanted in a low position. D, Second SAPIEN valve positioned within the first valve. E, Second SAPIEN valve implanted in the correct position. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Types of bioprosthetic aortic valves. A, Stented valve example (Hancock 2) demonstrating its structure. B, Stentless valve example demonstrating the fluoroscopic appearance. C, Stentless valve example (Freestyle valve) demonstrating its structure. D, Stentless valve example (Freestyle valve) demonstrating radiolucent characteristics. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Types of stentless valves and techniques of implantation. A, Subcoronary implantation. B, Full root implantation. C, Mini-root implantation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Relationship of coronary ostia and bioprosthesis. A, Stented valve. B, Stentless valve replaced as subcoronary implantation (arrow points to suture line). C, Cross-section of stentless valve subcoronary implantation demonstrating proximity of the suture line (large arrow) and coronary ostia (small arrow). D, Stentless valve replaced as full root, with suture line (large arrow) at the level of annulus and the coronary ostia have been reimplanted higher up (small arrow). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

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