Background: Valve-in-valve transcatheter heart valve (ViV THV) differs from native transcatheter heart valve (THV) in preprocedural assessment, procedure and anticipated complications during procedure. Transesophageal echocardiography (TEE) plays a supplemental role to guide cardiologist during procedure and helps in monitoring complications.
Methods: In this case report, we describe the TEE findings observed during a valve-in-valve transcatheter aortic valve replacement (ViV TAVR) procedure. The findings helped to guide the procedure, supplemented detecting a rare complication of malformed THV and thereby improved patient outcome.
Conclusion: TEE can prevent complications, detect abnormalities early, and improve patient outcome, when taken in conjunction with other imaging modalities.
Salem SA, Foerst JR. Valve-in-valve transcatheter aortic valve replacement, with present-day innovations and up-to-date techniques. Interv Cardiol Clin 2021;10(4):491–504. DOI: 10.1016/j.iccl.2021.06.005
Gheorghe L, Brouwer J, Gutierrez A, et al. Can TAVR be effectively and safely performed without intraprocedural TEE? Curr Cardiol Rep 2020;22(9):80. DOI: 10.1007/s11886-020-01344-8
Batta A, Satish S, Rajan A, et al. Strut inversion during valve-in-valve transcatheter aortic valve replacement: an unknown complication? JACC Case Rep 2022;4(8):460–463. DOI: 10.1016/j.jaccas.2021.12.015
New EuroSCORE I.I., 2011 [Internet]. Euroscore.org. 2022 [cited 3 May 2022] Available from: http://www.euroscore.org/calc.html
Fried L, Tangen C, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3):M146–M157. DOI: 10.1093/gerona/56.3.m146
Bhargava AA, Shekiladze N, Xie J, et al. Use of transesophageal echocardiography for transcatheter valve-in-valve implantation for patients with prior bioprosthetic surgical aortic, mitral, tricuspid, and pulmonic valves. Ann Cardiothorac Surg 2021;10(5):605–620. DOI: 10.21037/acs-2021-tviv-27
Hahn RT, Little SH, Monaghan MJ, et al. Recommendations for comprehensive intraprocedural echocardiographic imaging during TAVR. JACC Cardiovasc Imaging 2015;8(3):261–287. DOI: 10.1016/j.jcmg.2014.12.014
Higuchi R, Tobaru T, Naito K, et al. Salvage transcatheter aortic valve implantation for severe acute aortic regurgitation complicating percutaneous transluminal aortic valvuloplasty. J Cardiol Cases 2016;14(6):174–176. DOI: 10.1016/j.jccase.2016.08.007
Tay EL, Gurvitch R, Wijeysinghe N, et al. Outcome of patients after transcatheter aortic valve embolization. JACC Cardiovasc Interv 2011;4(2):228–234. DOI: 10.1016/j.jcin.2010.10.010
