Associazione Nazionale Medici Cardiologi Ospedalieri




Costantino Marco Fabio Potenza(Potenza) – Cardiovascular Department – “San Carlo” Hospital | Stolfi Luisiana Potenza(Potenza) – Cardiovascular Department – “San Carlo” Hospital | D’Addeo Gianpaolo Potenza(Potenza) – Cardiovascular Department – “San Carlo” Hospital

Introduction: The Valve-in-Valve Transcatheter Aortic Valve Replacement (ViV-TAVR) procedure is a valid alternative treatment to surgery.

Aim: This study evaluates, from a clinical and echocardiographic point of view, the immediate and one-year postprocedural outcome of the ViV-TAVR in case of dysfunction of a biological prosthesis at the aortic site.

Materials and methods: Between 2021 and 2022, 17 consecutive patients with stenosis (64.71%) or aortic valve insufficiency (35.29%) underwent ViV-TAVR procedure and we evaluated them echocardiographically for 12 months.

Results: The implanted valves (10 of 20 mm, 5 of 23 mm, 1 of 26 mm and one of 29 mm in diameter) were Sapien XT type in 4 patients and Sapien 3 in 13 cases (of which 3 Ultra). We reported the Kaplan-Meier curve referring to one-year mortality in the presence/absence of coronary heart disease. Degeneration of bioprostheses in patients aged < 70 years at the time of implantation occurred on average in 10.89±2.98 years, in patients aged >70 years in 7.88±2.23 years after implantation intervention. For all patients we calculated the mean change in end-diastolic volume (EDV) between the value at baseline, immediately after ViV-TAVR and at one-year follow-up. On patients who had bioprosthesis dysfunction with stenosis, we calculated the change in the mean transvalvular gradient (Gm) and Doppler Velocity Index (DVi) at baseline, immediately after ViV-TAVR and at follow-up.

Conclusions: The analyzed echocardiographic parameters were improved after ViV-TAVR both in the immediate post-procedural and in the follow-up period.