ArticleBMC cardiovascular disorders2026
Hemodynamic performance of valve-in-valve-in-valve implantation for transcatheter heart valve: an in vitro simulation study.
Article in BMC cardiovascular disorders, 2026. 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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Abstract
BACKGROUND&
objectiveValve-in-valve-in-valve (ViViV) implantation will be considered after the second valve deterioration as an increasing number of patients aged < 60 years undergo transcatheter aortic valve replacement (TAVR). We aimed to investigate the hemodynamic outcomes after ViViV procedures.
methodEvolut and Venus A with size of 23 mm and 26 mm were selected for the testing. Cardiovascular hydrodynamic tests were conducted using the in Vitro Pulse Duplicator system.
resultViViV configuration of 26 mm-in-26 mm-in-26 mm demonstrates a larger effective orifice area (EOA) than the 23 mm-in-26 mm-in-26 mm configuration. The transvalvular mean pressure gradient (MPG) of three 26 mm combination were 8.3 ± 1.9 mmHg for Venus-A and 13.2 ± 1.6 mmHg for Evolut, which were acceptable.
conclusionThe ViViV valve combination employing three 26 mm Venus-A or Evolut self-expanding valves, as opposed to the 23 mm-in-26 mm-in-26 mm configuration, exhibited favorable hemodynamic performance as demonstrated by in the vitro testing.
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