ArticleJACC. Case reports2025
High-Risk TAV-in-TAV: Balloon-Expandable TAVR in a Degenerated Mechanically Expanded Valve.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
objectiveThe objective of this study is to describe a high-risk transcatheter aortic valve-in-valve in a Lotus valve requiring coronary artery protection. KEY STEPS: Thorough preoperative assessment for valve sizing and coronary obstruction risk assessment are performed. Access is obtained for a pigtail catheter, a guiding catheter for percutaneous coronary intervention, and the transcatheter aortic valve replacement delivery system. Coronary access is secured with a coronary wire and a guide extension catheter before valve deployment. Proper alignment of the new valve is ensured. A snorkel stent is deployed and maximal expansion is ensured. POTENTIAL PITFALLS: Coronary artery anatomy, which is at high risk for obstruction, can lead to coronary ischemia or sequestration after valve deployment. Improper alignment of the new valve can lead to poor apposition and paravalvular leak. Injury to the aorta during valve deployment or when postdilation is required. TAKE-HOME MESSAGE: Successful transcatheter aortic valve-in-valve in a Lotus valve is feasible with proper preoperative planning, individualized device selection, and coronary protection when indicated.
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