Pulmonary valve-in-valve implants: how long do they prolong reintervention and what causes them to fail?

BACKGROUND

The valve-in-valve (VinV) procedure is a minimally invasive, transcatheter, off-pump, alternative to conventional valve replacement, which uses a failing bioprosthesis to anchor a second transcatheter-delivered prosthesis. This technique appears effective for prolonging freedom from reintervention and treating early device failure. However, it is unknown as to how long reintervention can be avoided.

METHODS

We present the pathological findings of a VinV explanted after 47 months, as well as the failure modes of these devices.

RESULTS

The VinV approach in our case ultimately failed, likely due to the proximity of the host's tissues to the prosthetic device, resulting in a combination of pannus, calcification, and a cusp tear.

CONCLUSIONS

Additional long-term follow-up of pulmonary VinV implantations is needed in order to determine the life span of VinVs and what causes them to fail.