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Valve-in-Valve for Transcatheter Aortic Valve Replacement: Do Imaging Requirements Change?

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Multimodality Imaging for Transcatheter Aortic Valve Replacement

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Abstract

Bioprosthetic surgical valves have shorter durability compared to mechanical devices and the risk of reoperation is often prohibitively high. Contemporary transcatheter valves have been, and will continue to be, successfully deployed within failing surgical prostheses utilizing a valve-in-valve technique. Detailed knowledge of the physical characteristics of the in situ surgical prosthesis is crucial for procedural success. Currently, the internal diameter of the surgical valve is the most important dimension used to size transcatheter valves. Unfortunately, there is significant variability in both labeling and reported dimensions between surgical valve manufacturers with no accepted gold standard. Multiple novel transcatheter valve systems are currently being developed for valve-in-valve applications that utilize a variety of innovative sizing criteria. Imaging plays a key role in all aspects of valve-in-valve implantation. Multidetector computed tomography (MDCT) can help size existing surgical prosthesis and is proving invaluable for next-generation device development and refinement. Although echocardiography provides important periprocedural guidance for radiolucent surgical prostheses, a detailed understanding of the radiopaque surgical landmarks is crucial for correct valve-in-valve positioning and thus successful implantation.

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Author information

Authors and Affiliations

  1. Division of Cardiology, Vancouver General Hospital, 9th Floor Diamond Health Care Centre, 2775 Laurel St, Vancouver, BC, V6B2W6, Canada

    Rohan Poulter MD, MBBS, MRCP(UK), FRACP

  2. Department of Cardiothoracic Surgery, Guys and St. Thomas’ Hospital, 6th Floor East Wing, Westminster Bridge Road, London, SE1 7EH, UK

    Vinayak Bapat FRCS, CTh

  3. Division of Cardiology, St. Paul’s and Vancouver General Hospital, Diamond Health Care Centre (Cardiology – Level 9), 2775 Laurel St, Vancouver, BC, V6B2W6, Canada

    David A. Wood MD, FRCPC

Authors
  1. Rohan Poulter MD, MBBS, MRCP(UK), FRACP
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  2. Vinayak Bapat FRCS, CTh
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  3. David A. Wood MD, FRCPC
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Corresponding author

Correspondence to Rohan Poulter MD, MBBS, MRCP(UK), FRACP .

Editor information

Editors and Affiliations

  1. NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA

    James K. Min

  2. Departments of Imaging and Medicine, David Geffen UCLA School of Medicine, Cedars-Sinai Medical Center Cedars-Sinai Heart Institute, Los Angeles, California, USA

    Daniel S. Berman

  3. Department of Cardiology, St. Paul’s Hospital, University of British Columbia Department of Radiology, Vancouver, British Columbia, Canada

    Jonathon Leipsic

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Poulter, R., Bapat, V., Wood, D.A. (2014). Valve-in-Valve for Transcatheter Aortic Valve Replacement: Do Imaging Requirements Change?. In: Min, J., Berman, D., Leipsic, J. (eds) Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer, London. https://doi.org/10.1007/978-1-4471-2798-7_32

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  • DOI: https://doi.org/10.1007/978-1-4471-2798-7_32

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  • Online ISBN: 978-1-4471-2798-7

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