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J Am Coll Cardiol, 2007; 50:56-60, doi:10.1016/j.jacc.2007.03.030 (Published online 17 June 2007).
© 2007 by the American College of Cardiology Foundation
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Valve-in-a-Valve Concept for Transcatheter Minimally Invasive Repeat Xenograft Implantation

Thomas Walther, MD, PhD*,*, Volkmar Falk, MD, PhD*, Todd Dewey, MD{ddagger}, Jörg Kempfert, MD*, Fabian Emrich, MD*, Bettina Pfannmüller, MD*, Petra Bröske, DVM*, Michael A. Borger, MD, PhD*, Gerhard Schuler, MD, PhD{dagger}, Michael Mack, MD{ddagger} and Friedrich W. Mohr, MD, PhD*

* Klinik für Herzchirurgie, Leipzig, Germany
{dagger} Kardiologie, Herzzentrum, Universität Leipzig, Leipzig, Germany
{ddagger} Department of Cardiac Surgery, Cardiopulmonary Research Science and Technology Institute, Dallas, Texas.


Figure 1
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  		Figure 1 Edwards Sapien Stent-Fixed Transcatheter Xenograft as Used for the Current Study

Valve size and stent diameter is 23 mm. (A) Outflow view. (B) Lateral view.

 

Figure 2
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  		Figure 2 VinV Implantation in the Aortic Position Within a Conventional 23-mm Carpentier Edwards Porcine Prosthesis

(A) Partial dilatation of the balloon. (B) Full dilatation of the balloon. (C) Optimal valve positioning after dilatation. (D) Aortic root angiography showing good valve-in-a-valve (VinV) function and patent coronary arteries.

 

Figure 3
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  		Figure 3 VinV Implantation in the Mitral Position Within a Conventional 25-mm Carpentier Edwards Porcine Prosthesis

(A) Valve positioning within the conventional mitral valve prosthesis. The superstiff guidewire is passed from the apex retrogradely through the mitral prosthesis, curves in the left atrium, and is anchored in a pulmonary vein. (B) Mitral valve-in-a-valve (VinV) in position.

 

Figure 4
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  		Figure 4 Macroscopic and Radiological View of a 23-mm Edwards Sapien Xenograft Within a 23-mm Conventional Carpentier Edwards Porcine Prosthesis After Explantation

(A) Macroscopic inflow view. (B) Macroscopic lateral view. (C) Radiological inflow view. (D) Radiological lateral view.

 




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