Below is a comprehensive review of performing transcatheter valve-in-valve implantation for a failed surgical bioprosthetic valves (open access).
When bioprosthetic cardiac valves fail, reoperative valve replacement carries a higher risk of morbidity and mortality compared with initial valve replacement. Transcatheter heart valve implantation may be a viable alterna- tive to surgical aortic valve replacement for high-risk patients with native aortic stenosis, and valve-in-valve (V- in-V) implantation has been successfully performed for failed surgical bioprostheses in the aortic, mitral, pulmonic, and tricuspid positions. Despite some core similarities to transcatheter therapy of native valve disease, V-in-V therapy poses unique clinical and anatomic challenges. In this paper, we review the challenges, selection criteria, techniques, and outcomes of V-in-V implantation. (J Am Coll Cardiol 2011;58:2196–209)