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

Chapter

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.

Keywords

Bioprosthetic valve Transcatheter valve Valve-in-valve Internal diameter Fluoroscopic markers 

References

  1. 1.
    Ruel M, Chan V, Bedard P, Kulik A, Ressler L, Lam BK, Rubens FD, Goldstein W, Hendry PJ, Masters RG, Mesana TG. Very long-term survival implications of heart valve replacement with tissue versus mechanical prostheses in adults <60 years of age. Circulation. 2007;116(11 Suppl):I294–300.PubMedGoogle Scholar
  2. 2.
    Chikwe J, Filsoufi F. Durability of tissue valves. Semin Thorac Cardiovasc Surg. 2011;23(1):18–23.PubMedCrossRefGoogle Scholar
  3. 3.
    Grunkemeier GL, Jamieson WR, Miller DC, Starr A. Actuarial versus actual risk of porcine structural valve deterioration. J Thorac Cardiovasc Surg. 1994;108(4):709–18.PubMedGoogle Scholar
  4. 4.
    Balsam LB, Grossi EA, Greenhouse DG, Ursomanno P, Deanda A, Ribakove GH, Culliford AT, Galloway AC. Reoperative valve surgery in the elderly: predictors of risk and long-term survival. Ann Thorac Surg. 2010;90(4):1195–200; discussion 1201.PubMedCrossRefGoogle Scholar
  5. 5.
    Jones JM, O’Kane H, Gladstone DJ, Sarsam MA, Campalani G, MacGowan SW, Cleland J, Cran GW. Repeat heart valve surgery: risk factors for operative mortality. J Thorac Cardiovasc Surg. 2001;122(5):913–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Maganti M, Rao V, Armstrong S, Feindel CM, Scully HE, David TE. Redo valvular surgery in elderly patients. Ann Thorac Surg. 2009;87(2):521–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Leontyev S, Borger MA, Davierwala P, Walther T, Lehmann S, Kempfert J, Mohr FW. Redo aortic valve surgery: early and late outcomes. Ann Thorac Surg. 2011;91(4):1120–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Beurtheret S, Gariboldi V, Feier H, Grisoli D, Riberi A, Mouly-Bandini A, Metras D, Kerbaul F, Collart F. Short-term results of repeat valve replacement: a predictive factor analysis. J Heart Valve Dis. 2010;19(3):326–32.PubMedGoogle Scholar
  9. 9.
    Lytle BW, Cosgrove DM, Taylor PC, Gill CC, Goormastic M, Golding LR, Stewart RW, Loop FD. Reoperations for valve surgery: perioperative mortality and determinants of risk for 1,000 patients, 1958–1984. Ann Thorac Surg. 1986;42(6):632–43.PubMedCrossRefGoogle Scholar
  10. 10.
    Piehler JM, Blackstone EH, Bailey KR, Sullivan ME, Pluth JR, Weiss NS, Brookmeyer RS, Chandler JG. Reoperation on prosthetic heart values. Patient-specific estimates of in-hospital events. J Thorac Cardiovasc Surg. 1995;109(1):30–48.PubMedCrossRefGoogle Scholar
  11. 11.
    Kirsch M, Nakashima K, Kubota S, Houel R, Hillion ML, Loisance D. The risk of reoperative heart valve procedures in Octogenarian patients. J Heart Valve Dis. 2004;13(6):991–6; discussion 996.PubMedGoogle Scholar
  12. 12.
    Boone RH, Webb JG, Horlick E, Benson L, Cao QL, Nadeem N, Kiess M, Hijazi ZM. Transcatheter pulmonary valve implantation using the Edwards SAPIEN transcatheter heart valve. Catheter Cardiovasc Interv. 2010;75(2):286–94.PubMedCrossRefGoogle Scholar
  13. 13.
    Cerillo AG, Chiaramonti F, Murzi M, Bevilacqua S, Cerone E, Palmieri C, Del Sarto P, Mariani M, Berti S, Glauber M. Transcatheter valve-in-valve implantation for failed mitral and tricuspid bioprosthesis. Catheter Cardiovasc Interv. 2011;78(7):987–95.PubMedCrossRefGoogle Scholar
  14. 14.
    Cheung AW, Gurvitch R, Ye J, Wood D, Lichtenstein SV, Thompson C, Webb JG. Transcatheter transapical mitral valve-in-valve implantations for a failed bioprosthesis: a case series. J Thorac Cardiovasc Surg. 2011;141(3):711–5.PubMedCrossRefGoogle Scholar
  15. 15.
    de Weger A, Tavilla G, Ng AC, Delgado V, van der Kley F, Schuijf JD, Bax JJ, Klautz RJ. Successful transapical transcatheter valve implantation within a dysfunctional mitral bioprosthesis. JACC Cardiovasc Imaging. 2010;3(2):222–3.PubMedCrossRefGoogle Scholar
  16. 16.
    Gotzmann M, Mugge A, Bojara W. Transcatheter aortic valve implantation for treatment of patients with degenerated aortic bioprostheses–valve-in-valve technique. Catheter Cardiovasc Interv. 2010;76(7):1000–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Kempfert J, Van Linden A, Linke A, Borger MA, Rastan A, Mukherjee C, Ender J, Schuler G, Mohr FW, Walther T. Transapical off-pump valve-in-valve implantation in patients with degenerated aortic xenografts. Ann Thorac Surg. 2010;89(6):1934–41.PubMedCrossRefGoogle Scholar
  18. 18.
    Khambadkone S, Coats L, Taylor A, Boudjemline Y, Derrick G, Tsang V, Cooper J, Muthurangu V, Hegde SR, Razavi RS, Pellerin D, Deanfield J, Bonhoeffer P. Percutaneous pulmonary valve implantation in humans: results in 59 consecutive patients. Circulation. 2005;112(8):1189–97.PubMedCrossRefGoogle Scholar
  19. 19.
    Khawaja MZ, Haworth P, Ghuran A, Lee L, de Belder A, Hutchinson N, Trivedi U, Laborde JC, Hildick-Smith D. Transcatheter aortic valve implantation for stenosed and regurgitant aortic valve bioprostheses CoreValve for failed bioprosthetic aortic valve replacements. J Am Coll Cardiol. 2010;55(2):97–101.PubMedCrossRefGoogle Scholar
  20. 20.
    Maroto LC, Rodriguez JE, Cobiella J, Marcos P. Transapical off-pump aortic valve-in-a-valve implantation in two elderly patients with a degenerated porcine bioprosthesis. Eur J Cardiothorac Surg. 2010;37(3):738–40.PubMedCrossRefGoogle Scholar
  21. 21.
    McElhinney DB, Hellenbrand WE, Zahn EM, Jones TK, Cheatham JP, Lock JE, Vincent JA. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 2010;122(5):507–16.PubMedCrossRefGoogle Scholar
  22. 22.
    Montorfano M, Latib A, Chieffo A, Moshiri S, Franco A, Grimaldi A, Alfieri O, Colombo A. Successful percutaneous anterograde transcatheter valve-in-valve implantation in the mitral position. JACC Cardiovasc Interv. 2011;4(11):1246–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Pasic M, Unbehaun A, Dreysse S, Buz S, Drews T, Kukucka M, Hetzer R. Transapical aortic valve implantation after previous aortic valve replacement: clinical proof of the “valve-in-valve” concept. J Thorac Cardiovasc Surg. 2011;142(2):270–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Roberts PA, Boudjemline Y, Cheatham JP, Eicken A, Ewert P, McElhinney DB, Hill SL, Berger F, Khan D, Schranz D, Hess J, Ezekowitz MD, Celermajer D, Zahn E. Percutaneous tricuspid valve replacement in congenital and acquired heart disease. J Am Coll Cardiol. 2011;58(2):117–22.PubMedCrossRefGoogle Scholar
  25. 25.
    Seiffert M, Franzen O, Conradi L, Baldus S, Schirmer J, Meinertz T, Reichenspurner H, Treede H. Series of transcatheter valve-in-valve implantations in high-risk patients with degenerated bioprostheses in aortic and mitral position. Catheter Cardiovasc Interv. 2010;76(4):608–15.PubMedCrossRefGoogle Scholar
  26. 26.
    Van Garsse LA, Ter Bekke RM, van Ommen VG. Percutaneous transcatheter valve-in-valve implantation in stenosed tricuspid valve bioprosthesis. Circulation. 2011;123(5):e219–21.PubMedCrossRefGoogle Scholar
  27. 27.
    Webb JG, Wood DA, Ye J, Gurvitch R, Masson JB, Rodes-Cabau J, Osten M, Horlick E, Wendler O, Dumont E, Carere RG, Wijesinghe N, Nietlispach F, Johnson M, Thompson CR, Moss R, Leipsic J, Munt B, Lichtenstein SV, Cheung A. Transcatheter valve-in-valve implantation for failed bioprosthetic heart valves. Circulation. 2010;121(16):1848–57.PubMedCrossRefGoogle Scholar
  28. 28.
    Christakis GT, Buth KJ, Goldman BS, Fremes SE, Rao V, Cohen G, Borger MA, Weisel RD. Inaccurate and misleading valve sizing: a proposed standard for valve size nomenclature. Ann Thorac Surg. 1998;66(4):1198–203.PubMedCrossRefGoogle Scholar
  29. 29.
    Shibata T, Inoue K, Ikuta T, Bito Y, Yoshioka Y, Mizoguchi H. Which valve and which size should we use in the valve-on-valve technique for re-do mitral valve surgery? Interact Cardiovasc Thorac Surg. 2009;8(2):206–10.PubMedCrossRefGoogle Scholar
  30. 30.
    Cribier A, Eltchaninoff H, Tron C, Bauer F, Agatiello C, Nercolini D, Tapiero S, Litzler PY, Bessou JP, Babaliaros V. Treatment of calcific aortic stenosis with the percutaneous heart valve: mid-term follow-up from the initial feasibility studies: the French experience. J Am Coll Cardiol. 2006;47(6):1214–23.PubMedCrossRefGoogle Scholar
  31. 31.
    Azadani AN, Jaussaud N, Matthews PB, Chuter TA, Ge L, Guy TS, Guccione J, Tseng EE. Aortic valve-in-valve implantation: impact of transcatheter- bioprosthesis size mismatch. J Heart Valve Dis. 2009;18(4):367–73.PubMedGoogle Scholar
  32. 32.
    Azadani AN, Jaussaud N, Matthews PB, Ge L, Chuter TA, Tseng EE. Transcatheter aortic valves inadequately relieve stenosis in small degenerated bioprostheses. Interact Cardiovasc Thorac Surg. 2010;11(1):70–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Azadani AN, Tseng EE. Transcatheter heart valves for failing bioprostheses: state-of-the-art review of valve-in-valve implantation. Circ Cardiovasc Interv. 2011;4(6):621–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Bapat V, Mydin I, Chadalavada S, Tehrani H, Attia R, Thomas M. A guide to fluoroscopic identification and design of bioprosthetic valves: a reference for valve-in-valve procedure. Catheter Cardiovasc Interv. 2013;81:853–61.PubMedCrossRefGoogle Scholar
  35. 35.
    Binder RK, Leipsic J, Wood D, Moore T, Toggweiler S, Willson A, Gurvitch R, Freeman M, Webb JG. Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography. Circ Cardiovasc Interv. 2012;5:247–52.PubMedCrossRefGoogle Scholar
  36. 36.
    Gurvitch R, Wood DA, Leipsic J, Tay E, Johnson M, Ye J, Nietlispach F, Wijesinghe N, Cheung A, Webb JG. Multislice computed tomography for prediction of optimal angiographic deployment projections during transcatheter aortic valve implantation. JACC Cardiovasc Interv. 2010;3(11):1157–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Division of CardiologyVancouver General HospitalVancouverCanada
  2. 2.Department of Cardiothoracic SurgeryGuys and St. Thomas’ HospitalLondonUK
  3. 3.Division of CardiologySt. Paul’s and Vancouver General HospitalVancouverCanada

Personalised recommendations