Search

An increasing number of surgical aortic bioprostheses (SAVR) have been implanted in recent years, and increasingly more patients will be candidates for reintervention due to structural deterioration of the valve. Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has become a safe and effective alternative to surgery in highrisk patients with lower early mortality; however, as a complex procedure with many pitfalls, ViV-TAVI should be performed in high-volume centers with experienced staff. A higher risk of peri- and postprocedural complications involves prosthesis-patient mismatch with a risk of high residual gradient, a risk of coronary obstruction, or an increased risk of thrombosis of the leaflets of the bioprosthesis. An exact preproce‑ dural planning as well as detailed information and knowledge of specific features of the original bioprosthesis are all of crucial importance. The operator must be familiar with the proper implantation technique and selection of a suitable type of TAVI prosthesis for specific anatomy. Because TAVI is now available to younger patients with a longer life expectancy, a lifetime strategy of aortic stenosis treatment must be considered since the initial intervention will influence all future therapeutic choices. [ABSTRACT FROM AUTHOR]