The Essential Aortic Valve-in-Valve Transcatheter Aortic Valve Replacement Update: Procedural Strategies and Current Clinical Results

Abstract

Valve-in-valve transcatheter aortic valve replacement is an established alternative to conventional surgical reoperation for failed aortic bioprosthetic valves. The technique has undergone significant refinements in recent years, aiming to tackle pain points of the procedure such as subpar hemodynamics and coronary obstruction. In this state-of-the-art review, we aim to discuss these refinements, including novel surgical valves, transcatheter heart valve positioning, bioprosthetic valve fracture, and prevention of coronary obstruction, among others. We also summarize key updates on clinical trial data and contemporary outcomes of valve-in-valve transcatheter aortic valve replacement.