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Valve-in-Valve Implantation Is Effective Option

Procedure can immediately restore satisfactory valve function after bioprosthetic valve failure

TUESDAY, April 13 (HealthDay News) -- Transcatheter valve-in-valve implantation is an effective option for the management of bioprosthetic valve failure, according to a study published online April 12 in Circulation.

John G. Webb, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues performed transcatheter heart valve-in-valve implantations in 24 high-risk patients whose bioprosthetic valves had failed. Failed valves included 10 aortic, seven mitral, six pulmonary and one tricuspid bioprostheses.

The researchers found that the procedure was successful with immediate restoration of satisfactory valve function in all but one patient. After implantation, patients did not experience more than mild regurgitation. Thirty-day mortality was 4.2 percent, and no patients died during the procedure. At a median follow-up of 135 days and a maximum follow-up of 1,045 days, 91.7 percent of patients were alive with satisfactory valve function. While 88 percent of patients were in New York Heart Association functional class III or IV prior to surgery, final follow-up revealed 88 percent of patients were in class I or II.

"The advent of percutaneous device therapy for valvular heart disease is one of the most exciting events in cardiology in the last 50 years, and the work by Webb et al published here exemplifies the speed with which this technology is advancing," the author of an accompanying editorial writes.

Five co-authors disclosed serving as consultants for the heart valve company Edwards Lifesciences Inc., the manufacturer of equipment and devices used in the study.

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