First Report of Evolut Pro+ Transcatheter Aortic Valve-in-Valve in a Degenerated Lotus Valve

Thorald Stolte, BSc; David Winkel, MD; Philip Haaf, MD; Thomas Nestelberger, MD

Structural Heart (Jan 2024)

First Report of Evolut Pro+ Transcatheter Aortic Valve-in-Valve in a Degenerated Lotus Valve

Thorald Stolte, BSc,
David Winkel, MD,
Philip Haaf, MD,
Thomas Nestelberger, MD

Affiliations

Thorald Stolte, BSc: Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland; Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
David Winkel, MD: Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
Philip Haaf, MD: Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
Thomas Nestelberger, MD: Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland; Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland; Address correspondence to: Thomas Nestelberger, MD, Department of Cardiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.

Journal volume & issue: Vol. 8, no. 1
p. 100229

Abstract

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The increasing use of transcatheter aortic valves in patients with aortic stenosis has led to a higher number of valve-in-valve procedures due to gradual valve degeneration. We present a case of a 72-year-old woman who received transcatheter aortic valve implantation (TAVI) using a Lotus valve due to severe aortic stenosis, which showed valve degeneration several years after the initial procedure. After heart-team discussion, TAVI-in-TAVI was planned using an Evolut pro+ valve, which allowed for full coverage of the Lotus valve and maintenance of coronary flow, resulting in a well-functioning valve with no regurgitation and normal performance. Despite high-risk anatomic features, valve-in-valve using an Evolut pro+ in a degenerated Lotus valve is feasible and overcomes pitfalls such as entanglement or coronary obstruction.

Published in Structural Heart

ISSN: 2474-8706 (Print); 2474-8714 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/structural-heart

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