TAV-in-TAV Outcomes: Experience from a Single Institution

Vol V Issue VI
DOI: 10.5083ejcm20424884.166 , Cite or Link Using DOI
Creating a Digital Object Identifier Link

A digital object identifier (DOI) can be used to cite and link to electronic documents. A DOI is guaranteed never to change, so you can use it to link permanently to electronic documents.

To find a document using a DOI

  1. Copy the DOI of the document you want to open.
    The correct format for citing a DOI is as follows: doi:10.1016/S0140-6736(08)61345-8
  2. Open the following DOI site in your browser:
    dx.doi.org
  3. Enter the entire DOI citation in the text box provided, and then click Go.
    The document that matches the DOI citation will display in your browser window.

The DOI scheme is administered by the International DOI Foundation. Many of the world's leading publishers have come together to build a DOI-based document linking scheme known as CrossRef.

Jeremy R Burt, Ali M Agha, Madison Kocher, Aryan Zahergivar, Heather Collins,Usman Siddiqui

ABSTRACT Introduction: Dysfunction or malpositioning of the aortic valve prosthesis is an uncommon but a known complication. Deployment of a second transcatheter aortic valve within previously implanted transcatheter aortic valve prosthesis is referred to as TAV-in-TAV. This procedure is often performed to treat aortic regurgitation occurring shortly after transcatheter aortic valve replacement (TAVR). Objective: The purpose of our study was to see if TAVR approach (transfemoral vs. transapical) impacted the incidence of periprocedural TAVin-TAV. Methods: A retrospective record review of consecutive patients was performed at a single center. The incidence of periprocedural TAVin-TAV was recorded and compared between patients’ undergoing TAVR via transfemoral and transapical approach. Periprocedural complications and imaging findings were also recorded. Results: Out of 489 patients undergoing TAVR, only 10 patients (2%) required urgent periprocedural TAV-in-TAV, 5 patients each from the transfemoral and transapical groups (1.6% vs. 2.7%, respectively, p = 0.51). TAV-in-TAV deployment was technically successful in 8 patients (80%) and unsuccessful in 2 patients (20%; 1 transfemoral and 1 transapical), who required conversion to openheart surgery. The primary cause of TAVR failure requiring periprocedural TAV-in-TAV in both transfemoral and transapical patients was prosthesis malposition, frequently complicated by moderate to severe paravalvular aortic insufficiency. Statistically, there was no difference between the periprocedural morbidity and 30- day mortality for patients undergoing TAV-in-TAV via transfemoral versus transapical approach. Conclusion: Periprocedural TAV-in-TAV was uncommon in our cohort, primarily resulting from prosthesis malposition causing paravalvular aortic insufficiency. We found no difference in the number of patients requiring TAV-in-TAV in relation to TAVR approach.