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Transcatheter aortic valve replacement is increasingly being offered to younger and lower risk patients, including patients with previous surgical aortic valve replacement. The long-term outcome of valve-in-valve transcatheter aortic valve replacement after surgical valve replacement remains uncertain. We present the case of a fully thoracoscopic redo aortic valve replacement for symptomatic valve-in-valve stenosis after previous open surgical aortic valve replacement and secondary valve-in-valve transcatheter aortic valve replacement. This procedure has proven to be difficult and high risk, in part due to the redo nature of the operation and the extensive neo- endothelialization over the transcatheter aortic valve replacement stent frame. This article demonstrates the feasibility of a minimally invasive approach for transcatheter aortic valve replacement and bioprosthetic valve explant while simultaneously highlighting the essential role of the heart team in selecting the correct treatment strategy for patients with bioprosthetic valve degeneration.
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http://dx.doi.org/10.1510/mmcts.2024.126 | DOI Listing |
World J Pediatr Congenit Heart Surg
September 2025
Department of Pediatric Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Severe tricuspid regurgitation (TR) can lead to significant enlargement of the right atrium (RA) and poses unique clinical challenges. We report this case of a 17-year-old boy previously misdiagnosed with Ebstein anomaly who presented with dyspnea and palpitations. Initial examination revealed irregular heart rhythm, distended neck veins, and a significant murmur.
View Article and Find Full Text PDFMinerva Cardiol Angiol
September 2025
Norwich Medical School, Bob Champion Research and Education, Rosalind Franklin Road, Norwich, UK -
Introduction: Whilst aortic stenosis remains the most prevalent valvular abnormality, the management of asymptomatic severe aortic stenosis remains a clinical challenge. Recently, two randomised-controlled trials (RCTs) - EVOLVED (Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis) and Early TAVR (Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis) - have been published, alongside an extended follow-up from the AVATAR (Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis) study.
Evidence Acquisition: In response, we conducted a systematic review of PubMed, Ovid, and Cochrane databases, identifying RCTs up to October 29, 2024, that compared early intervention with conventional management.
JTCVS Open
August 2025
Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.
Objective: Valve selection in acute type A aortic dissection (ATAAD) requiring aortic root replacement is challenging given the clinical acuity, unknown patient preferences, risk of surgical bleeding, and limited life expectancy. We sought to identify long-term outcomes of mechanical versus bioprosthetic aortic root replacement in young patients with ATAAD.
Methods: Retrospective review of our institution's database of ATAAD was conducted to identify patients aged 65 years and younger who underwent mechanical Bentall (mech-Bentall) or bioprosthetic Bentall (bio-Bentall) for ATAAD from 2002 to 2022.
JTCVS Open
August 2025
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Objective: To compare the clinical outcomes of double-valve replacement (DVR) using bovine pericardial and porcine bioprostheses, using a nationwide administrative claims database.
Methods: Adult patients (age ≥40 years) who underwent bioprosthetic DVR between 2003 and 2018 were identified from the Korean National Health Insurance Service database. The outcomes of interest were all-cause mortality, cardiac mortality, and valve-related events, including the incidences of reoperation, endocarditis, systemic thromboembolism, and major bleeding.
JTCVS Open
August 2025
The State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, China.
Objectives: Left ventricular vortex dynamics play a crucial role in cardiac function but are significantly altered by mitral valve diseases or surgical interventions. Such hemodynamic changes may lead to maladaptive intracardiac vortices, potentially triggering pathways associated with progressive left ventricular remodeling and thrombosis. This study assessed left ventricular hemodynamics under both physiological and pathological conditions using a biohybrid in vitro platform, aiming to analyze the impact of these conditions on cardiac function.
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