The Valve-in-Valve Technique Can Salvage Percutaneous Aortic Valve Malposition

Device malpositioning resulting in severe paraprosthetic leak after transcatheter aortic valve implantation (TAVI) is an unfortunate outcome that can lead to hemodynamic compromise. Ussia and colleagues review their technique for addressing this complication with implantation of a second device, called the Valve-in-Valve (ViV) technique. Only 3.6% of patients who underwent TAVI with the 18-F CoreValve ReValving System (Medtronic, Inc., Minneapolis, Minnesota) required the ViV technique. There were no 30-day major adverse cerebrovascular and cardiac events in these patients, and there was a significant improvement in the mean transaortic gradient that was not different from those patients who underwent a single valve deployment. These results confirm the feasibility, safety, and efficacy of the ViV technique for revising valve malposition