Transcatheter aortic valve replacement for bioprosthetic aortic valve failure: The valve-in-valve procedure

摘要

Bioprosthetic valves are increasingly used in patients with aortic stenosis. Compared with mechanical valves, bioprosthetic valves are associated with a lower risk of thrombo-embolic events and do not require long-term anticoagulation. However, bioprosthetic valves have limited durability; the best current valves can be expected to degenerate within 10 to 20 years, resulting in stenosis or regurgitation. Surgical valve replacement is the current standard of care for these patients. However, reoperative morbidity and mortality risk is significant, not only because of the complexity of reoperation but also because many of these patients have comorbidities, particularly advanced age.