A Guide to Transcatheter Aortic Valve Design and Systematic Planning for a Redo-TAV (TAV-in-TAV) Procedure

Vinayak N Bapat; Miho Fukui; Syed Zaid; Atsushi Okada; Hasan Jilaihawi; Toby Rogers; Omar Khalique; João L Cavalcante; Uri Landes; Janarthanan Sathananthan; Giuseppe Tarantini; Gilbert H L Tang; Daniel J Blackman; Ole De Backer; Michael J Mack; Martin B Leon

doi:10.1016/j.jcin.2024.04.047

A Guide to Transcatheter Aortic Valve Design and Systematic Planning for a Redo-TAV (TAV-in-TAV) Procedure

JACC Cardiovasc Interv. 2024 Jul 22;17(14):1631-1651. doi: 10.1016/j.jcin.2024.04.047.

Authors

Vinayak N Bapat¹, Miho Fukui², Syed Zaid³, Atsushi Okada², Hasan Jilaihawi⁴, Toby Rogers⁵, Omar Khalique⁶, João L Cavalcante⁷, Uri Landes⁸, Janarthanan Sathananthan⁹, Giuseppe Tarantini¹⁰, Gilbert H L Tang¹¹, Daniel J Blackman¹², Ole De Backer¹³, Michael J Mack¹⁴, Martin B Leon¹⁵

Affiliations

¹ Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA; Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. Electronic address: vnbapat@yahoo.com.
² Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
³ Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas, USA.
⁴ Cedars-Sinai Medical Center, The Smidt Heart Institute, Los Angeles, California, USA.
⁵ MedStar Washington Hospital Center, Washington, DC, USA.
⁶ Division of Cardiovascular Imaging at St. Francis Hospital, New York, New York, USA.
⁷ Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA; Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
⁸ Edith Wolfson Medical Center, Cardiology Department, Tel-Aviv University, Holon, Israel.
⁹ St. Paul's Hospital, Vancouver, British Columbia, Canada.
¹⁰ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy.
¹¹ Mount Sinai Hospital, New York, New York, USA.
¹² Leeds Teaching Hospitals, Leeds, United Kingdom.
¹³ The Heart Center, Copenhagen University Hospital, Copenhagen, Denmark.
¹⁴ Baylor Scott & White Health, Dallas, Texas, USA.
¹⁵ Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA.

PMID: 39048251
DOI: 10.1016/j.jcin.2024.04.047

Abstract

Transcatheter aortic valve replacement (TAVR) has become more common than surgical aortic valve replacement since 2016, with over 200,000 procedures globally each year. As patients increasingly outlive their TAVR devices, managing these cases is a growing concern. Treatment options include surgical removal of the old TAVR device (transcatheter aortic valve [TAV] explant) or implantation of a new transcatheter aortic valve (redo TAV). Redo TAV is complex because of the unique designs of TAV devices; compatibility issues; and the need for individualized planning based on factors such as implant depth, shape, and coronary artery relationships. This review serves as a comprehensive guide for redo TAV, detailing the design characteristics of TAV devices, device compatibility, standardized terminology, and a structured approach for computed tomography analysis. It aims to facilitate decision making, risk identification, and achieving optimal outcomes in redo TAV procedures.

Keywords: TAVR; computed tomography; reintervention.

Publication types

Review

MeSH terms

Aortic Valve Stenosis / diagnostic imaging
Aortic Valve Stenosis / physiopathology
Aortic Valve Stenosis / surgery
Aortic Valve* / diagnostic imaging
Aortic Valve* / physiopathology
Aortic Valve* / surgery
Clinical Decision-Making
Heart Valve Prosthesis*
Humans
Predictive Value of Tests
Prosthesis Design*
Reoperation*
Risk Factors
Terminology as Topic
Transcatheter Aortic Valve Replacement* / adverse effects
Transcatheter Aortic Valve Replacement* / instrumentation
Treatment Outcome