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Bernard Iung, Alec Vahanian, Coronary obstruction: a rare but devastating complication during transcatheter aortic valve-in-valve implantation, European Heart Journal, Volume 39, Issue 8, 21 February 2018, Pages 696–698, https://doi.org/10.1093/eurheartj/ehx529
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This editorial refers to ‘Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry’†, by H.B. Ribeiro et al., on page 687.
Transcatheter implantation of a prosthesis in a degenerated aortic bioprosthesis [valve-in-valve (ViV)] was initially an off-label application of transcatheter aortic valve implantation (TAVI), which rapidly appeared of interest since patients with degenerated bioprostheses are likely to be at higher risk for surgery than those with native aortic stenosis. Transcatheter ViV is now recognized as an option for patients at high risk for surgery in American and European guidelines.1 , 2 Transcatheter aortic ViV accounted for 3.3% of all TAVI procedures between 2012 and 2015 in the Society of Thoracic Surgeons/American College of Cardiology (ACC) Transcatheter Valve Therapy Registry, and the rate of ViV increased from 1.7% between 2010 and 2012 to 4.4% between 2013 and 2015 in the FRANCE-2 and FRANCE TAVI registries.3 , 4 The number of ViV procedures is likely to increase in the future given the growing use of bioprostheses over the last decades, in particular in younger patients. 5 , 6