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Tesi etd-01122022-222113

Type of thesis
Master univ. II liv.
Author
BORGHESI, MARCO
URN
etd-01122022-222113
Title
The "russian doll" effect: a valve-in-valve-in-valve procedure.
Structure
Istituto di Scienze della Vita
Course
Corsi Alta Formazione - PERCUTANEOUS INTERVENTIONAL TREATMENT OF STRUCTURAL HEART DISEASES
Committee
relatore BERTI, SERGIO
Membro PASSINO, CLAUDIO
Keywords
  • Aortic regurgitation
  • Complications
  • TAVR
  • TAVR-in-SHV
  • TAVR-in-THV
  • ViV
Exam session start date
21/01/2022;
Availability
completa
Abstract
In the last years in the interventions of surgical aortic valve replacemant there was a substantial shift worldwide torward the use of bioposthesis rather than mechanical valve also in younger patients, to avoid life-time oral anticoagulation. However bioprostheses have limited durability and most are expected to degenerate and eventually fail within ten to twenty years. Valve-in-Valve with TAVR is emerging as a minimal invasive procedure alternative to surgical redo. I presented a case of Valve-in-Valve procedure (THV-in-SHV) for bioprosthesis aortic valve disfunction complicated by severe paravalvular leak with the need of a second Valve-in-Valve procedure (THV-in-THV) that resulted in patient-prosthesis mismatch. This case is emblematic of the next future in wich we will treat an increasingly number of younger patients with a degenerate bioprosthetic SHV (or THV) that could be need one or more re-interventions during their life-time as well as coronary interventions. So it will be more and more important to develop procedural protocols, universally recognized, and, on the other hand, a more tailored and meticolous planning of the procedure, and maybe also a new generation of devices more performing.
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