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Heart. 2019 Mar;105(Suppl 2):s38-s43. doi: 10.1136/heartjnl-2018-313517.

Transcatheter aortic valve replacement in failed surgical valves.

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Division of Cardiovascular Surgery, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
Division of Cardiology, University of Washington, Seattle, Washington, United States of America.


Aortic valve-in-valve is a less invasive alternative to surgical redo in the treatment of failed bioprosthetic valves. While only inoperable patients underwent the procedure before, operators currently offer it to those at lower risk and worldwide experience is in the thousands. Early mortality has diminished in recent analyses and improvements in symptoms and quality of life have been documented. Main considerations with aortic valve-in-valve include elevated postprocedural gradients, coronary obstruction and leaflet thrombosis. Risk factors for each of these adverse events have been described at length. Aortic valve-in-valve offers a safe and effective option in the management of failed bioprosthetic valves.


bicuspid aortic valve; transcatheter valve interventions

Conflict of interest statement

Competing interests: None declared.

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