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Catheter Cardiovasc Interv. 2009 Mar 1;73(4):530-9. doi: 10.1002/ccd.21822.

Implantation of two self-expanding aortic bioprosthetic valves during the same procedure-Insights into valve-in-valve implantation ("Russian doll concept").

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Interventional Cardiology Department, Erasmus MC, Thoraxcenter, Rotterdam, the Netherlands.


Transcatheter aortic valve implantation has gained acceptance as a treatment for elderly patients considered high risk for surgical aortic valve replacement. There are still, however, many unresolved clinical and technical issues. The occurrence of transcatheter aortic valve-in-valve implantation has been reported anecdotally. Aside from a single case report, there is little literature on this topic. This study was conducted to evaluate the procedural, imaging, and clinical outcomes of patients who underwent transcatheter valve-in-valve implantation with two self-expanding aortic valve bioprostheses during the same procedure. We discuss also the potential valve of on-line quantitative angiography for assessing the depth of valve implantation and the need to implant a second valve.

[Indexed for MEDLINE]

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