TAV-in-TAV in patients with prosthesis embolization: Impact of commissural alignment and global outcomes

Optimal strategies to manage embolization of transcatheter aortic valve implantation (TAVI) devices are unclear; valve-in-valve (ViV) is often used. We aimed to describe through one-single center experience its rate, causes, consequences, and management as well as the rate and relevance of commissur...

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Published in:International journal of cardiology 2024-09, Vol.410, p.132179, Article 132179
Main Authors: Gómez-Herrero, Javier, Fernandez-Cordón, Clara, Gonzalez, Jose Carlos, García-Gómez, Mario, Turrión, Sara Blasco, Serrador, Ana, Gutiérrez, Hipólito, Campo, Alberto, Cortés, Carlos, Sevilla, Teresa, Aristizabal, Christian, Ruiz, Julio, Campillo, Sofía, Baladrón, Carlos, Carrasco-Moraleja, Manuel, Román, J. Alberto San, Amat-Santos, Ignacio J.
Format: Article
Language:English
Subjects:
Commissural alignment
Coronary arteries re-access
Embolization
TAVR
Valve-in-valve
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Summary:Optimal strategies to manage embolization of transcatheter aortic valve implantation (TAVI) devices are unclear; valve-in-valve (ViV) is often used. We aimed to describe through one-single center experience its rate, causes, consequences, and management as well as the rate and relevance of commissural alignment (CA) in this context. We identified across 1038 TAVI cases, those cases requiring ViV for the management of first device embolization. CA (absence or mild misalignment) after first and second device was assessed by CT or fluoroscopy. A total of 23 cases (2.2%) were identified, 52.3% embolized towards the aorta and 47.7% towards the ventricle. Suboptimal implant height (38%) and embolization at the time of post-dilation (23%) were the most frequent mechanisms together with greater rate of bicuspid valve (p 
ISSN:0167-5273
1874-1754
1874-1754
DOI:10.1016/j.ijcard.2024.132179