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You are here: Contents > 2015 > Volume 24 Number 4 July 2015 > REPLACEMENT DEVICE EVALUATION > Feasibility of Valve-in-Valve Procedure for Degenerated St. Jude Medical Trifecta™ Bioprosthesis

Feasibility of Valve-in-Valve Procedure for Degenerated St. Jude Medical Trifecta™ Bioprosthesis

Jean-Philippe Verhoye1,2, Majid Harmouche1,2, Reda Belhaj Soulami1, Christophe Thebault3, Dominique Boulmier3, Alain Leguerrier1, Amedeo Anselmi1,2

1Division of Thoracic, Cardiac and Vascular Surgery, Pontchaillou University Hospital, Rennes, 2Research Unit INSERM 1099, University of Rennes 1, Rennes, 3Division of Cardiology, Pontchaillou University Hospital, Rennes, France

The valve-in-valve (ViV) procedure is an option for patients with symptomatic structural degeneration of a bioprosthesis and excessive reoperative risk. The risk of coronary obstruction appears to be increased if ViV is performed for certain pericardial prostheses in which the leaflets are mounted outside the stent posts. Herein is described a successful ViV for a degenerated Trifecta aortic bioprosthesis, and the technical considerations for performing a ViV procedure within such types of prosthesis are considered. Emphasis is placed on the importance of

preoperative investigations (computed tomography scan-based measurements of coronary ostial height and of sinus of Valsalva diameters), and on the precise deployment of the valve (transapical approach with transesophageal echocardiography control) to minimize the risk of major complications. The presence of a failing Trifecta bioprosthesis should not be considered an absolute contraindication to ViV on the basis of the risk of coronary obstruction.

The Journal of Heart Valve Disease 2015;24:484-486


Feasibility of Valve-in-Valve Procedure for Degenerated St. Jude Medical TrifectaBioprosthesis

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